Uremic Toxicity: Urea and Beyond

@article{Depner2001UremicTU,
  title={Uremic Toxicity: Urea and Beyond},
  author={Thomas A. Depner},
  journal={Seminars in Dialysis},
  year={2001},
  volume={14}
}
  • T. Depner
  • Published 1 July 2001
  • Medicine, Biology
  • Seminars in Dialysis
Successful replacement of renal function with dialysis supports the concept that uremia is a toxic state resulting from accumulated solutes and that toxicity results from high concentrations of these solutes in body fluids. Dialyzer clearance of urea, a surrogate toxin, is the currently accepted best measure of dialysis and dialysis adequacy, but it is admittedly a compromise due to current lack of knowledge about and inability to measure more toxic solutes. This failure could be explained if… 
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TLDR
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Improving Clearance for Renal Replacement Therapy.
TLDR
Here, a variety of methods that could be used to increase the clearance of such nonurea solutes are reviewed to test the extent to which increasing solute clearances improves patients' health.
Improving Solute Clearances by Hemodialysis.
TLDR
Methods which could be employed to increase the clearance of nonurea solutes with various characteristics, including the clearances of free low-molecular-mass solutes, free largersolutes, and protein-bound solutes are reviewed.
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  • 2005
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Treatment Time, Chronic Inflammation, and Hemodynamic Stability: The Overlooked Parameters in Hemodialysis Quantification
TLDR
The relationships between dialysis clearance, treatment time, chronic inflammation, volume control, and hemodynamic stability are explored and it is proposed that a better understanding of these complex relationships may provide opportunities for improving outcomes of maintenance hemodialysis patients.
Plasma pseudouridine levels reflect body size in children on hemodialysis
TLDR
Prescribing dialysis based on urea kinetics may leave uremic solutes at higher levels in small children, and measurement of a solute produced proportional to BSA may provide a better index of dialysis adequacy than measurement of urea.
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