New insights into uremic toxicity

Amanda C. Raff, Timothy W. Meyer, Thomas H. Hostetter

Research output: Contribution to journalArticle

62 Citations (Scopus)

Abstract

Purpose of review: Our concept of uremia has expanded to encompass the illness patients begin to suffer as glomerular filtration rate declines long before the onset of end-stage renal disease (ESRD) not explained by known derangements in volume status or metabolic parameters. New insights into the accumulation of uremic toxins and the loss of function of hormones and enzymes provide important information on the etiology of uremia. Recent findings New data are accumulating on the identity and toxicity of uremic toxins and the syndromes that encompass uremia. p-Cresol sulfate and indoxyl sulfate are small, protein-bound molecules that are poorly cleared with dialysis. These molecules have been linked to cardiovascular disease and oxidative injury. Impaired immunity plays a central role in the morbidity of ESRD and may be both the result of uremic toxicity and a contributor to oxidative stress in ESRD. Uremic cachexia is an underrecognized uremic syndrome. New insights into disordered feeding circuits in ESRD may lead to novel therapies using hormone agonists. Summary Mortality in ESRD remains unacceptably high. It is hoped that as knowledge emerges on the causes and consequences of uremia, we are embarking on an era not only of new insights but also new and effective treatments for patients with the ill effects of uremia.

Original languageEnglish (US)
Pages (from-to)560-565
Number of pages6
JournalCurrent Opinion in Nephrology and Hypertension
Volume17
Issue number6
DOIs
StatePublished - Nov 2008

Fingerprint

Uremia
Chronic Kidney Failure
Indican
Hormones
Cachexia
Glomerular Filtration Rate
Dialysis
Immunity
Oxidative Stress
Cardiovascular Diseases
Morbidity
Mortality
Wounds and Injuries
Enzymes
Therapeutics
Proteins

Keywords

  • Indoxyl sulfate
  • Oxidative stress
  • p-Cresol sulfate
  • Uremia
  • Uremic anorexia
  • Uremic immune dysregulation
  • Uremic toxins

ASJC Scopus subject areas

  • Nephrology
  • Internal Medicine

Cite this

New insights into uremic toxicity. / Raff, Amanda C.; Meyer, Timothy W.; Hostetter, Thomas H.

In: Current Opinion in Nephrology and Hypertension, Vol. 17, No. 6, 11.2008, p. 560-565.

Research output: Contribution to journalArticle

Raff, Amanda C. ; Meyer, Timothy W. ; Hostetter, Thomas H. / New insights into uremic toxicity. In: Current Opinion in Nephrology and Hypertension. 2008 ; Vol. 17, No. 6. pp. 560-565.
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