The quest for a better understanding of chronic kidney disease complications: an update on uremic toxins

• Autor(a) principal: Barreto,Fellype Carvalho
• Data de Publicação: 2014
• Outros Autores: Stinghen,Andréa Emilia Marques, Oliveira,Rodrigo Bueno de, Franco,Ana Tereza Barufi, Moreno,Andréa Novais, Barreto,Daniela Veit, Pecoits-Filho,Roberto, Drüeke,Tilman B., Massy,Ziad A.
• Tipo de documento: Artigo
• Idioma: eng
• Título da fonte: Jornal Brasileiro de Nefrologia
• Texto Completo: http://old.scielo.br/scielo.php?script=sci_arttext&pid=S0101-28002014000200221
• topic: cardiovascular diseases; dialysis; kidney failure, chronic; uremia

Chronic kidney disease is characterized by a progressive reduction of glomerular filtration rate and/or the appearance of proteinuria, and subsequently the progressive retention of organic waste compounds called uremic toxins (UT). Over the last decades, a large number of such compounds have been identified and their effects on organs and tissues, especially the cardiovascular system, has been demonstrated. In this review, we present the current classification of UT, as proposed by the EUTox Group, and the effects of some of the probably most important UTs, such as phosphate, FGF-23, PTH, AGEs, indoxyl sulfate and para-cresyl sulfate. We provide an overview on therapeutic approaches aimed to increase their extracorporeal removal via convective and/or adsorptive strategies and to lower their intestinal production/ absorption via dietetic and pharmacological interventions. The recognition that multiple toxins contribute to the uremia supports the need for new therapeutic targets, with a potentially positive impact on CKD progression and survival.