Blog entry by Meguid El Nahas

Anyone in the world

Prof Bassam Saeed wrote:

 

ERA-EDTA congress update:
New uraemic toxins: For chronic cardiovascular problems, protein-bound solutes and middle molecules play an essential role.

The new tools made available by the advent of genomic, proteomic, and metabolomic research techniques e.g. mass spectrometry (MS) will result in the identification of several additional uraemic retention solutes. We often focus on the important role of small water-soluble compounds for acute mortality, but that for the chronic Cardiovascular problems of the uraemic syndrome, protein-bound solutes and middle molecules seem to play a more essential role. guanidino compounds, indoxylsulfate... It has been shown that dialytic Removal of middle molecules can be increased by the use of high-flux membranes and further enhanced by adding convection, although data for protein-bound solutes remain less convincing, with post dilution HDF being the most efficient of the available convective strategies. Only a few studies suggest that outcome improves with dialysis on high-flux membranes. Complementary, alternative removal methods (e.g. adsorption) and pharmaceutical strategies blocking responsible pathways could contribute to the aim of improving outcome of CKD patients and might even have implications for a much larger population, perhaps as early as CKD stage 3 (GFR < 60 ml⁄min).
[ Modified: Thursday, 1 January 1970, 1:00 AM ]