Normal and Pathologic Concentrations of Uremic Toxins : Journal of the American Society of Nephrology (original) (raw)

Clinical Research

Duranton, Flore*; Cohen, Gerald†; De Smet, Rita‡; Rodriguez, Mariano§; Jankowski, Joachim‖; Vanholder, Raymond‡; Argiles, Angel* on behalf of the European Uremic Toxin Work Group

*RD-Néphrologie, Montpellier, France;

†Medizinische Universität Wien, University Klinik für Innere Medizin III, Abteilung für Nephrologie und Dialyse, Wien, Austria;

‡Nephrology Section, University Hospital Ghent, Gent, Belgium;

§Unidad de Investigacion, University Hospital Reina Sofia, Cordoba, Spain; and

‖Charité, Experimental Nephrology and Hypertension, Berlin, Germany

Correspondence: Dr. Àngel Argilés, RD-Néphrologie, 104 rue de la Galéra, FR-34090 Montpellier, France. Email: [email protected]

Received December 14, 2011

Accepted April 13, 2012

Abstract

An updated review of the existing knowledge regarding uremic toxins facilitates the design of experimental studies. We performed a literature search and found 621 articles about uremic toxicity published after a 2003 review of this topic. Eighty-seven records provided serum or blood measurements of one or more solutes in patients with CKD. These records described 32 previously known uremic toxins and 56 newly reported solutes. The articles most frequently reported concentrations of β2-microglobulin, indoxyl sulfate, homocysteine, uric acid, and parathyroid hormone. We found most solutes (59%) in only one report. Compared with previous results, more recent articles reported higher uremic concentrations of many solutes, including carboxymethyllysine, cystatin C, and parathyroid hormone. However, five solutes had uremic concentrations less than 10% of the originally reported values. Furthermore, the uremic concentrations of four solutes did not exceed their respective normal concentrations, although they had been previously described as uremic retention solutes. In summary, this review extends the classification of uremic retention solutes and their normal and uremic concentrations, and it should aid the design of experiments to study the biologic effects of these solutes in CKD.