title: Clinical management of the uraemic syndrome in chronic kidney disease.
abstract: The clinical picture of the uraemic syndrome is a complex amalgam of accelerated ageing and organ dysfunction, which progress in parallel to chronic kidney disease. The uraemic syndrome is associated with cardiovascular disease, metabolic bone disease, inflammation, protein energy wasting, intestinal dysbiosis, anaemia, and neurological and endocrine dysfunction. In this Review, we summarise specific, modern management options for the uraemic syndrome in chronic kidney disease. Although large randomised controlled trials are scarce, based on data from randomised controlled trials and observational studies, as well as pathophysiological reasoning, a therapeutic algorithm can be developed for this complex and multifactorial condition, with interventions targeting several modifiable factors simultaneously.
authors.affiliation: Nephrology Section, Department of Internal Medicine, Ghent University Hospital, Ghent, Belgium. Electronic address: raymond.vanholder@ugent.be.
authors.forename: Raymond
authors.initials: R
authors.lastname: Vanholder
authors.affiliation: Department of Nephrology-Nutrition-Dialysis, Centre Hospitalier Lyon Sud, Carmen-CENS, Université Claude Bernard Lyon 1, Lyon, France; Investigation Network Initiative Cardiovascular and Renal Clinical Trialists (INI-CRCT), French Clinical Research Infrastructure Network (F-CRIN), Nancy, France.
authors.forename: Denis
authors.initials: D
authors.lastname: Fouque
authors.affiliation: Nephrology Section, Department of Internal Medicine, Ghent University Hospital, Ghent, Belgium.
authors.forename: Griet
authors.initials: G
authors.lastname: Glorieux
authors.affiliation: Department of Internal Medicine IV, Saarland University Medical Centre, Homburg, Germany.
authors.forename: Gunnar H
authors.initials: GH
authors.lastname: Heine
authors.affiliation: Department of Medicine, Division of Nephrology, Koc University School of Medicine, Istanbul, Turkey.
authors.forename: Mehmet
authors.initials: M
authors.lastname: Kanbay
authors.affiliation: Nephrology, Dialysis and Transplantation Unit, and CNR-IFC Clinical Epidemiology and Pathophysiology of Renal Diseases and Hypertension, Ospedali Riuniti, Reggio Calabria, Italy.
authors.forename: Francesca
authors.initials: F
authors.lastname: Mallamaci
authors.affiliation: Investigation Network Initiative Cardiovascular and Renal Clinical Trialists (INI-CRCT), French Clinical Research Infrastructure Network (F-CRIN), Nancy, France; Division of Nephrology, Ambroise Paré University Hospital (APHP), University of Paris Ouest, Versailles-Saint-Quentin-en-Yvelines (UVSQ), Boulogne-Billancourt, Paris, France; INSERM U1018, Research Centre in Epidemiology and Population Health (CESP), UVSQ, Villejuif, France.
authors.forename: Ziad A
authors.initials: ZA
authors.lastname: Massy
authors.affiliation: Division of Nephrology, IIS-Fundacion Jimenez Diaz, Madrid, Spain.
authors.forename: Alberto
authors.initials: A
authors.lastname: Ortiz
authors.affiliation: Investigation Network Initiative Cardiovascular and Renal Clinical Trialists (INI-CRCT), French Clinical Research Infrastructure Network (F-CRIN), Nancy, France; INSERM Centre d'Investigations Cliniques (CIC)-1433, and INSERM U1116, Nancy, France; Institut Lorrain du Cœur et des Vaisseaux, CHU Nancy, Vandoeuvre lès Nancy, France; Université de Lorraine, Nancy, France; Association Lorraine pour le Traitement de l'Insuffisance Rénale, Vandoeuvre lès Nancy, France.
authors.forename: Patrick
authors.initials: P
authors.lastname: Rossignol
authors.affiliation: Department of Nephrology, Transplantation and Internal Medicine, Medical University of Silesia, Katowice, Poland.
authors.forename: Andrzej
authors.initials: A
authors.lastname: Wiecek
authors.affiliation: Nephrology, Dialysis and Transplantation Unit, and CNR-IFC Clinical Epidemiology and Pathophysiology of Renal Diseases and Hypertension, Ospedali Riuniti, Reggio Calabria, Italy.
authors.forename: Carmine
authors.initials: C
authors.lastname: Zoccali
authors.affiliation: Investigation Network Initiative Cardiovascular and Renal Clinical Trialists (INI-CRCT), French Clinical Research Infrastructure Network (F-CRIN), Nancy, France; INSERM U970, Hôpital Européen Georges Pompidou, Paris.
authors.forename: Gérard Michel
authors.initials: GM
authors.lastname: London
mesh_terms: D019468:Disease Management; D006801:Humans; D051436:Renal Insufficiency, Chronic / Q000150:complications* / Q000503:physiopathology; D013577:Syndrome; D014511:Uremia / Q000209:etiology / Q000628:therapy*