title: The quest for a better understanding of chronic kidney disease complications: an update on uremic toxins.
abstract: 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.
authors: Pontifical Catholic University of Paraná.
authors: Fellype Carvalho
authors: FC
authors: Barreto
authors: Federal University of Paraná.
authors: Andréa Emilia Marques
authors: AE
authors: Stinghen
authors: University of São Paulo.
authors: Rodrigo Bueno
authors: RB
authors: de Oliveira
authors: Nove de Julho University.
authors: Ana Tereza Barufi
authors: AT
authors: Franco
authors: Pontifical Catholic University of Paraná.
authors: Andréa Novais
authors: AN
authors: Moreno
authors: Pontifical Catholic University of Paraná.
authors: Daniela Veit
authors: DV
authors: Barreto
authors: Pontifical Catholic University of Paraná.
authors: Roberto
authors: R
authors: Pecoits-Filho
authors: Université de Picardie Jules Verne.
authors: Tilman B
authors: TB
authors: Drüeke
authors: Université de Picardie Jules Verne.
authors: Ziad A
authors: ZA
authors: Massy
mesh_terms: D000089703:Fibroblast Growth Factor-23; D005346:Fibroblast Growth Factors; D017127:Glycation End Products, Advanced; D006146:Guanidines; D006801:Humans; D007200:Indican; D020738:Leptin; D010281:Parathyroid Hormone; D010710:Phosphates; D051436:Renal Insufficiency, Chronic / Q000150:complications* / Q000209:etiology / Q000628:therapy; D014118:Toxins, Biological; D014511:Uremia / Q000150:complications; D014527:Uric Acid
chemical_list: C000717427:FGF23 protein, human; D017127:Glycation End Products, Advanced; D006146:Guanidines; D020738:Leptin; D010281:Parathyroid Hormone; D010710:Phosphates; D014118:Toxins, Biological; D014527:Uric Acid; D005346:Fibroblast Growth Factors; D000089703:Fibroblast Growth Factor-23; D007200:Indican