期刊
CLINICAL JOURNAL OF THE AMERICAN SOCIETY OF NEPHROLOGY
卷 16, 期 12, 页码 1918-1928出版社
AMER SOC NEPHROLOGY
DOI: 10.2215/CJN.02660221
关键词
uremia; dialysis; middle molecule; definition; classification
Advances in research on uremic retention solutes and improvements in dialysis techniques have provided opportunities for redefining and classifying uremic toxins. The focus is on hemodialysis for removing uremic retention solutes, with an emphasis on identifying biomarkers for different classes and their correlation to clinical symptoms. Recommendations for future research aim to improve understanding of uremic solutes and patient outcomes in CKD.
Advances in our understanding of uremic retention solutes, and improvements in hemodialysis membranes and other techniques designed to remove uremic retention solutes, offer opportunities to readdress the definition and classification of uremic toxins. A consensus conference was held to develop recommendations for an updated definition and classification scheme on the basis of a holistic approach that incorporates physicochemical characteristics and dialytic removal patterns of uremic retention solutes and their linkage to clinical symptoms and outcomes. The major focus is on the removal of uremic retention solutes by hemodialysis. The identification of representative biomarkers for different classes of uremic retention solutes and their correlation to clinical symptoms and outcomes may facilitate personalized and targeted dialysis prescriptions to improve quality of life, morbidity, and mortality. Recommendations for areas of future research were also formulated, aimed at improving understanding of uremic solutes and improving outcomes in patients with CKD.
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