title: Approaches to uremia.
abstract: The development of dialysis was a dramatic step forward in medicine, allowing people who would soon have died because of lack of kidney function to remain alive for years. We have since found, however, that the "artificial kidney" does not live up fully to its name. Dialysis keeps patients alive but not well. Part of the residual illness that dialysis patients experience is caused by retained waste solutes that dialysis does not remove as well as native kidney function does. New means are available to identify these toxic solutes, about which we currently know remarkably little, and knowledge of these solutes would help us to improve therapy. This review summarizes our current knowledge of toxic solutes and highlights methods being explored to identify additional toxic solutes and to enhance the clearance of these solutes to improve patient outcomes.
authors.affiliation: Department of Medicine, Veterans Affairs Palo Alto Healthcare System, Palo Alto, California; Department of Medicine, Stanford University, Palo Alto, California; and twmeyer@stanford.edu.
authors.forename: Timothy W
authors.initials: TW
authors.lastname: Meyer
authors.affiliation: Department of Medicine, Case Western Reserve University, Cleveland, Ohio.
authors.forename: Thomas H
authors.initials: TH
authors.lastname: Hostetter
mesh_terms: D000818:Animals; D006801:Humans; D007676:Kidney Failure, Chronic / Q000150:complications* / Q000628:therapy; D007684:Kidney Tubules / Q000378:metabolism; D006435:Renal Dialysis; D014508:Urea / Q000097:blood; D014511:Uremia / Q000097:blood / Q000209:etiology*
chemical_list: D014508:Urea
keywords: chronic dialysis; urea; uremia