Biochemical and Clinical Impact of Organic Uremic Retention Solutes: A Comprehensive Update
| العنوان: | Biochemical and Clinical Impact of Organic Uremic Retention Solutes: A Comprehensive Update |
|---|---|
| المؤلفون: | Eva Schepers, Griet Glorieux, Anneleen Pletinck, Raymond Vanholder |
| المصدر: | Toxins TOXINS Toxins, Vol 10, Iss 1, p 33 (2018) |
| سنة النشر: | 2017 |
| مصطلحات موضوعية: | 0301 basic medicine, CHRONIC KIDNEY-DISEASE, patho-physiology CKD, Health, Toxicology and Mutagenesis, uremic toxins, 030232 urology & nephrology, lcsh:Medicine, Plasma protein binding, Review, Toxicology, chemistry.chemical_compound, 0302 clinical medicine, uremia, Glycation, cardiovascular disease, water-soluble uremic solutes, Chronic Kidney Disease, Medicine and Health Sciences, TOXIN PHENYLACETIC ACID, ATRIAL-NATRIURETIC-PEPTIDE, Chemistry, uremic toxicity, COLONY-STIMULATING FACTOR, middle molecules, Biochemistry, protein bound uremic solutes, Toxicity, CORONARY-ARTERY-DISEASE, Ghrelin, GLYCATION END-PRODUCTS, Protein Binding, This publication contains a comprehensive overview of the current knowledge on uremic toxicity, as well as an estimation of the degree of toxicity attributed to each individual toxin, and a classification according to the degree of known toxicity, water-soluble uremic, DICARBOXYLIC-ACID, 03 medical and health sciences, RETINOL-BINDING-PROTEIN, medicine, FURAN, CKD, Animals, Humans, NITRIC-OXIDE SYNTHASE, Toxins, Biological, solutes, lcsh:R, fibrosis, Water, medicine.disease, Uremia, Retinol binding protein, 030104 developmental biology, Solubility, inflammation, Uric acid, CHRONIC-RENAL-FAILURE, Asymmetric dimethylarginine |
| الوصف: | In this narrative review, the biological/biochemical impact (toxicity) of a large array of known individual uremic retention solutes and groups of solutes is summarized. We classified these compounds along their physico-chemical characteristics as small water-soluble compounds or groups, protein bound compounds and middle molecules. All but one solute (glomerulopressin) affected at least one mechanism with the potential to contribute to the uremic syndrome. In general, several mechanisms were influenced for each individual solute or group of solutes, with some impacting up to 7 different biological systems of the 11 considered. The inflammatory, cardio-vascular and fibrogenic systems were those most frequently affected and they are one by one major actors in the high morbidity and mortality of CKD but also the mechanisms that have most frequently been studied. A scoring system was built with the intention to classify the reviewed compounds according to the experimental evidence of their toxicity (number of systems affected) and overall experimental and clinical evidence. Among the highest globally scoring solutes were 3 small water-soluble compounds [asymmetric dimethylarginine (ADMA); trimethylamine-N-oxide (TMAO); uric acid], 6 protein bound compounds or groups of protein bound compounds [advanced glycation end products (AGEs); p-cresyl sulfate; indoxyl sulfate; indole acetic acid; the kynurenines; phenyl acetic acid;] and 3 middle molecules [(2)-microglobulin; ghrelin; parathyroid hormone). In general, more experimental data were provided for the protein bound molecules but for almost half of them clinical evidence was missing in spite of robust experimental data. The picture emanating is one of a complex disorder, where multiple factors contribute to a multisystem complication profile, so that it seems of not much use to pursue a decrease of concentration of a single compound. |
| وصف الملف: | application/pdf |
| تدمد: | 2072-6651 |
| الوصول الحر: | https://explore.openaire.eu/search/publication?articleId=doi_dedup___::235f395f98b4e73208f045731178578aTest https://pubmed.ncbi.nlm.nih.gov/29316724Test |
| حقوق: | OPEN |
| رقم الانضمام: | edsair.doi.dedup.....235f395f98b4e73208f045731178578a |
| قاعدة البيانات: | OpenAIRE |
| تدمد: | 20726651 |
|---|