Journal
BLOOD PURIFICATION
Volume 35, Issue -, Pages 45-50Publisher
KARGER
DOI: 10.1159/000346223
Keywords
Uremic toxins; Protein-bound toxins; Indoxyl sulfate; p-Cresylsulfate; Hemodiafiltration; Removal; Uremia
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Funding
- Fresenius Medical Care
- Baxter Health Care
- Gambro
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Protein-bound uremic retention solutes, i.e. phenolic compounds, such as p-cresylsulfate, and indolic compounds, such as indoxyl sulfate, have been intensively studied in recent years and have been shown to be associated especially with cardiovascular toxicity and adverse outcomes in chronic kidney disease. In this review, we will focus on their toxicity and their removal by dialysis strategies, which is hampered due to their protein binding. Hemodiafiltration slightly improves the removal of protein-bound solutes as compared to hemodialysis, although the clinical benefit on outcomes still needs to be demonstrated. Removal by means of absorption and interference with intestinal generation or renal tubular excretion are interesting alternative strategies under investigation. Copyright (C) 2013 S. Karger AG, Basel
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