title: Reconsidering the Lack of Urea Toxicity in Dialysis Patients.
abstract: Urea is an old uremic toxin which has been used for many years as a global biomarker of CKD severity and dialysis adequacy. Old studies were not in favor of its role as a causal factor in the pathogenesis of complications associated with the uremic state. However, recent experimental and clinical evidence is compatible with both direct and indirect toxicity of urea, particularly via the deleterious actions of urea-derived carbamylated molecules. Further studies are clearly needed to explore the potential relevance of urea-related CKD complications for patient management, in particular the place of new therapeutic strategies to prevent urea toxicity.
authors.affiliation: Division of Nephrology, Ambroise Paré Hospital, APHP, Versailles Saint-Quentin-en-Yvelines University (Paris-Ile-de-France-Ouest University, UVSQ), Boulogne Billancourt/Paris, France. ziad.massy@aphp.fr.|Inserm U-1018 Team 5, Paris-Saclay University and UVSQ, Villejuif, France. ziad.massy@aphp.fr.
authors.forename: Ziad A
authors.initials: ZA
authors.lastname: Massy
authors.affiliation: Department of Pediatrics, Nephrology Unit, University Hospital of Reims, Reims, France.|Laboratoire de Biochimie et de biologie moléculaire, Faculté de médecine, Université de Reims Champagne-Ardenne, CNRS UMR 7369 (Matrice Extracellulaire et Dynamique Cellulaire, MEDyC), Reims, France.
authors.forename: Christine
authors.initials: C
authors.lastname: Pietrement
authors.affiliation: Laboratoire de néphrologie, Faculté de médecine, Université de Reims Champagne-Ardenne, CNRS UMR 7369 (Matrice Extracellulaire et Dynamique Cellulaire, MEDyC), Reims, France.|Division of Nephrology, CHU Reims, Reims, France.
authors.forename: Fatouma
authors.initials: F
authors.lastname: Touré
mesh_terms: D015415:Biomarkers / Q000097:blood; D006801:Humans; D006435:Renal Dialysis; D014508:Urea / Q000097:blood*; D014511:Uremia / Q000175:diagnosis* / Q000517:prevention & control*
chemical_list: D015415:Biomarkers; D014508:Urea