The quest for a better understanding of chronic kidney disease complications: an update on uremic toxins

Jornal Brasileiro de Nefrologia

Fellype Carvalho Barreto¹  Andréa Emilia Marques Stinghen¹  Rodrigo Bueno De Oliveira¹  Ana Tereza Barufi Franco¹  Andréa Novais Moreno¹  Daniela Veit Barreto¹  Roberto Pecoits-filho¹  Tilman B. Drüeke¹  Ziad A. Massy¹ 

关键词: cardiovascular diseases;    dialysis;    kidney failure;    chronic;    uremia;    diálise;    doenças cardiovasculares;    falência renal crônica;    uremia;   

DOI  :  10.5935/0101-2800.20140033

来源: SciELO

【 摘 要 】

Chronic kidney disease is characterized by a progressive reduction of glomerular filtration rate and/or the appearance of proteinuria, and subsequently the progressive retention of organic waste compounds called uremic toxins (UT). Over the last decades, a large number of such compounds have been identified and their effects on organs and tissues, especially the cardiovascular system, has been demonstrated. In this review, we present the current classification of UT, as proposed by the EUTox Group, and the effects of some of the probably most important UTs, such as phosphate, FGF-23, PTH, AGEs, indoxyl sulfate and para-cresyl sulfate. We provide an overview on therapeutic approaches aimed to increase their extracorporeal removal via convective and/or adsorptive strategies and to lower their intestinal production/ absorption via dietetic and pharmacological interventions. The recognition that multiple toxins contribute to the uremia supports the need for new therapeutic targets, with a potentially positive impact on CKD progression and survival.

【 授权许可】

CC BY   
 All the contents of this journal, except where otherwise noted, is licensed under a Creative Commons Attribution License