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[Uremic Toxins: how can we improve the removal today?]
G Ital Nefrol. 2017 Sep 28; 34(5):89-101.GI

Abstract

Uremic status results from a malfunctioning of kidneys due to the accumulation of compounds which, under normal conditions, are excreted or metabolized by the kidneys. If these compounds are biologically active, they are called uremic toxins. Such compounds have toxic effects on the cardio-vascular system. An useful classification, published by the European Uremic Toxin Work Group (EUTox) is: 1) small water-soluble compounds; 2) protein-bound compounds; 3) the larger "middle molecules". High-flux membranes and more efficient treatment techniques, like HDF, improve the removal of uremic toxins in the middle molecular-weight range, and recent studies suggest that these strategies have better results on the morbidity and mortality. Today new membranes, medium cut-off membranes (MCO), with increased pore size, allow for the removal of higher molecular-weight toxins, such as kappa and lambda light chains and/or mediators of inflammation. For toxins in the 15 to 45 KD-size range, MCO membranes improve the removal in comparison with high-flux HD and/or HDF. Therefore MCO membrane simplifies the treatment of HD patients with a removal spectrum that extend the current possibilities of the best available therapies for End Stage Renal Disease.

Authors+Show Affiliations

Nefrologia e Dialisi, ASST Rhodense, Milano, Italia.Nefrologia e Dialisi, ASST Rhodense, Milano, Italia.

Pub Type(s)

Journal Article
Review

Language

ita

PubMed ID

28963830

Citation

Teatini, Ugo, and Giorgio Romei Longhena. "[Uremic Toxins: How Can We Improve the Removal Today?]." Giornale Italiano Di Nefrologia : Organo Ufficiale Della Societa Italiana Di Nefrologia, vol. 34, no. 5, 2017, pp. 89-101.
Teatini U, Romei Longhena G. [Uremic Toxins: how can we improve the removal today?]. G Ital Nefrol. 2017;34(5):89-101.
Teatini, U., & Romei Longhena, G. (2017). [Uremic Toxins: how can we improve the removal today?]. Giornale Italiano Di Nefrologia : Organo Ufficiale Della Societa Italiana Di Nefrologia, 34(5), 89-101.
Teatini U, Romei Longhena G. [Uremic Toxins: How Can We Improve the Removal Today?]. G Ital Nefrol. 2017 Sep 28;34(5):89-101. PubMed PMID: 28963830.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - [Uremic Toxins: how can we improve the removal today?] AU - Teatini,Ugo, AU - Romei Longhena,Giorgio, Y1 - 2017/09/28/ PY - 2017/10/1/entrez PY - 2017/10/1/pubmed PY - 2018/6/9/medline KW - Hemodiafiltration KW - Hemodialysis KW - High-flux membranes KW - Medium cut-off membranes KW - Middle molecules KW - Uremic toxins SP - 89 EP - 101 JF - Giornale italiano di nefrologia : organo ufficiale della Societa italiana di nefrologia JO - G Ital Nefrol VL - 34 IS - 5 N2 - Uremic status results from a malfunctioning of kidneys due to the accumulation of compounds which, under normal conditions, are excreted or metabolized by the kidneys. If these compounds are biologically active, they are called uremic toxins. Such compounds have toxic effects on the cardio-vascular system. An useful classification, published by the European Uremic Toxin Work Group (EUTox) is: 1) small water-soluble compounds; 2) protein-bound compounds; 3) the larger "middle molecules". High-flux membranes and more efficient treatment techniques, like HDF, improve the removal of uremic toxins in the middle molecular-weight range, and recent studies suggest that these strategies have better results on the morbidity and mortality. Today new membranes, medium cut-off membranes (MCO), with increased pore size, allow for the removal of higher molecular-weight toxins, such as kappa and lambda light chains and/or mediators of inflammation. For toxins in the 15 to 45 KD-size range, MCO membranes improve the removal in comparison with high-flux HD and/or HDF. Therefore MCO membrane simplifies the treatment of HD patients with a removal spectrum that extend the current possibilities of the best available therapies for End Stage Renal Disease. SN - 1724-5990 UR - https://www.unboundmedicine.com/medline/citation/28963830/[Uremic_Toxins:_how_can_we_improve_the_removal_today] L2 - https://medlineplus.gov/dialysis.html DB - PRIME DP - Unbound Medicine ER -