| Theme | Uremic Toxins | |
|---|---|---|
| Title | Uremic toxins -- From the classical definition to the new concept | |
| Publish Date | 1998/04 | |
| Author | Masashi Suzuki | Kidney Center of Shinraku-En Hospital |
| [ Summary ] | In the terminal stage of kidney disease, a variety of clinical symptoms are recognized. "Uremia" was proposed to mean "urine in the blood" by Piorry and L'Heritier in 1840. Subsequently, more than 2,000 toxic substances were reported in uremic blood. Then, Bergstrom and Furst, in 1978, proposed minimal criteria for the identification of uremic toxins: 1) which should be chemically identifiable and quantifiable in biological fluids; 2) the concentration in uremic subjects should exceed that in nonuremic subjects; 3) the concentration should correlate with specific uremic symptoms that disappear at the normal concentration; 4) toxic effects in a test system should be demonstrable at the concentration found in uremic subjects. All of these criteria are rarely met, however, often for technical reasons. Recently, the concept of uremic toxins has changed. Thus, the definition proposed by Bergstrom and Furst should be considered classical. In the new concept, the substances that damage normal physiological functions, or interfere with physiological defence mechanisms in renal failure have also been recognized as "uremic toxins". Some may play a role in the progression of renal disease, inducing uremic symptoms, and may contribute to dialysis-related complications. |
|