uremia

Summary

Summary: A clinical syndrome associated with the retention of renal waste products or uremic toxins in the blood. It is usually the result of RENAL INSUFFICIENCY. Most uremic toxins are end products of protein or nitrogen CATABOLISM, such as UREA or CREATININE. Severe uremia can lead to multiple organ dysfunctions with a constellation of symptoms.

Top Publications

  1. Holzer M, Birner Gruenberger R, Stojakovic T, El Gamal D, Binder V, Wadsack C, et al. Uremia alters HDL composition and function. J Am Soc Nephrol. 2011;22:1631-41 pubmed publisher
    ..Assessing HDL composition and function in renal disease may help identify patients at increased risk for cardiovascular disease...
  2. Chen D, Huang X, Yang M, Gan H, Gunawan E, Tang W. Treg/Th17 functional disequilibrium in Chinese uremia on hemodialysis: a link between calcification and cardiovascular disease. Ren Fail. 2012;34:697-702 pubmed publisher
  3. Peraldi M, Berrou J, Metivier F, Toubert A. Natural killer cell dysfunction in uremia: the role of oxidative stress and the effects of dialysis. Blood Purif. 2013;35 Suppl 2:14-9 pubmed publisher
    ..This decrease is associated with high circulating levels of the HLA-related molecule MICA. The dialysis membrane can influence the modulation of both the phenotype of NK cells and MICA overexpression...
  4. Mutsaers H, van den Heuvel L, Ringens L, Dankers A, Russel F, Wetzels J, et al. Uremic toxins inhibit transport by breast cancer resistance protein and multidrug resistance protein 4 at clinically relevant concentrations. PLoS ONE. 2011;6:e18438 pubmed publisher
    ..Moreover, calculated Ki values are below the maximal plasma concentrations of the tested toxins. In conclusion, this study shows that several uremic toxins inhibit active transport by MRP4 and BCRP at clinically relevant concentrations...
  5. Anders H, Andersen K, Stecher B. The intestinal microbiota, a leaky gut, and abnormal immunity in kidney disease. Kidney Int. 2013;83:1010-6 pubmed publisher
    ..We discuss how the metabolic alterations of uremia favor pathogen overgrowth (dysbiosis) in the gut and an increased translocation of living bacteria and bacterial ..
  6. Petrov M, Shilo V, Tarasov A, Schwartz D, Garcia J, Kost O, et al. Conformational changes of blood ACE in chronic uremia. PLoS ONE. 2012;7:e49290 pubmed publisher
    ..The pattern of binding of monoclonal antibodies (mAbs) to 16 epitopes on human angiotensin I-converting enzyme (ACE) comprise a conformational ACE fingerprint and is a sensitive marker of subtle protein conformational changes...
  7. Niwa T. Role of indoxyl sulfate in the progression of chronic kidney disease and cardiovascular disease: experimental and clinical effects of oral sorbent AST-120. Ther Apher Dial. 2011;15:120-4 pubmed publisher
    ..Experimental and clinical data demonstrate that AST-120 delays the progression not only of chronic kidney disease, but also of cardiovascular disease...
  8. Vaziri N, Yuan J, Rahimi A, Ni Z, Said H, Subramanian V. Disintegration of colonic epithelial tight junction in uremia: a likely cause of CKD-associated inflammation. Nephrol Dial Transplant. 2012;27:2686-93 pubmed publisher
    ..This study was designed to test the hypothesis that impaired intestinal barrier function in uremia must be due to disruption of the intestinal tight junction complex.
  9. Wang F, Zhang P, Jiang H, Cheng S. Gut bacterial translocation contributes to microinflammation in experimental uremia. Dig Dis Sci. 2012;57:2856-62 pubmed publisher
    Microinflammation frequently develops in chronic uremia with pathological intestinal changes. However, the relationship between gut bacterial translocation and microinflammation in uremia has not been widely investigated.

More Information

Publications62

  1. Teta D. Adipokines as uremic toxins. J Ren Nutr. 2012;22:81-5 pubmed publisher
    ..Obesity superimposed to uremia may further aggravate hyperadipokinemia, with the exception of adiponectinemia, which is mitigated by adiposity...
  2. Eloot S, Schepers E, Barreto D, Barreto F, Liabeuf S, Van Biesen W, et al. Estimated glomerular filtration rate is a poor predictor of concentration for a broad range of uremic toxins. Clin J Am Soc Nephrol. 2011;6:1266-73 pubmed publisher
    ..The purpose of this study was to investigate whether eGFR values are representative for uremic toxin concentrations in patients with different degrees of CKD...
  3. Noh H, Yu M, Kim H, Jeon J, Kwon S, Jin S, et al. Uremia induces functional incompetence of bone marrow-derived stromal cells. Nephrol Dial Transplant. 2012;27:218-25 pubmed publisher
    ..We hypothesized that inadequate angiogenic response in uremic patients could result from dysfunction of bone marrow-derived stromal cells [mesenchymal stem cells (MSCs)]...
  4. Miyamoto T, Carrero J, Stenvinkel P. Inflammation as a risk factor and target for therapy in chronic kidney disease. Curr Opin Nephrol Hypertens. 2011;20:662-8 pubmed publisher
    ..Inflammation is a major driving force of the uremic phenotype. This review provides an update on inflammatory biomarkers in chronic kidney disease and possible therapeutic approaches targeting the uremic inflammatory milieu...
  5. Rhee E, Thadhani R. New insights into uremia-induced alterations in metabolic pathways. Curr Opin Nephrol Hypertens. 2011;20:593-8 pubmed publisher
    This article summarizes recent studies on uremia-induced alterations in metabolism, with particular emphasis on the application of emerging metabolomics technologies.
  6. Duranton F, Cohen G, De Smet R, Rodriguez M, Jankowski J, Vanholder R, et al. Normal and pathologic concentrations of uremic toxins. J Am Soc Nephrol. 2012;23:1258-70 pubmed publisher
    ..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...
  7. Mutsaers H, Wilmer M, Reijnders D, Jansen J, van den Broek P, Forkink M, et al. Uremic toxins inhibit renal metabolic capacity through interference with glucuronidation and mitochondrial respiration. Biochim Biophys Acta. 2013;1832:142-50 pubmed publisher
    ..This may have a significant impact on drug and uremic retention solute disposition in CKD patients...
  8. Iwasaki Y, Kazama J, Yamato H, Shimoda H, Fukagawa M. Accumulated uremic toxins attenuate bone mechanical properties in rats with chronic kidney disease. Bone. 2013;57:477-83 pubmed publisher
    ..This mechanism may account for the increased prevalence of hip fracture among patients with CKD. ..
  9. Hwang J, Weng S, Weng R. High incidence of hepatocellular carcinoma in ESRD patients: caused by high hepatitis rate or 'uremia'? a population-based study. Jpn J Clin Oncol. 2012;42:780-6 pubmed publisher
    A high incidence of hepatocellular carcinoma has been reported in end-stage renal disease patients. This study was undertaken to evaluate whether this was caused by a high rate hepatitis or 'uremia' per se.
  10. Cohen G, Horl W. Immune dysfunction in uremia—an update. Toxins (Basel). 2012;4:962-90 pubmed publisher
    ..In uremia, the balance between pro- and anti-inflammatory and between pro- and anti-apoptotic factors is disturbed...
  11. Vitetta L, Gobe G. Uremia and chronic kidney disease: the role of the gut microflora and therapies with pro- and prebiotics. Mol Nutr Food Res. 2013;57:824-32 pubmed publisher
    b>Uremia is an illness that accompanies kidney failure and chronic kidney disease (CKD). Uremic illness is considered to be due largely to the accumulation of organic waste products that are normally cleared by the kidneys...
  12. De Schutter T, Behets G, Geryl H, Peter M, Steppan S, Gundlach K, et al. Effect of a magnesium-based phosphate binder on medial calcification in a rat model of uremia. Kidney Int. 2013;83:1109-17 pubmed publisher
    ..Thus, treatment with either CaMg or sevelamer effectively controlled serum phosphate levels in CRF rats and reduced aortic calcification...
  13. Custódio M, Koike M, Neves K, dos Reis L, Graciolli F, Neves C, et al. Parathyroid hormone and phosphorus overload in uremia: impact on cardiovascular system. Nephrol Dial Transplant. 2012;27:1437-45 pubmed publisher
    Cardiac remodeling in uremia is characterized by left ventricular hypertrophy, interstitial fibrosis and microvascular disease...
  14. Pavone B, Sirolli V, Giardinelli A, Bucci S, Forlì F, Di Cesare M, et al. Plasma protein carbonylation in chronic uremia. J Nephrol. 2011;24:453-64 pubmed publisher
    ..Chronic uremia may be associated with an increased carbonyl overload ("carbonyl stress"), though carbonyl formation has ..
  15. Waki K, Hayashi A, Ikeda S, Ikeda S, Nagatsuka K, Honma Y, et al. Measuring platelet aggregation in dialysis patients with a whole blood aggregometer by the screen filtration pressure method. Ther Apher Dial. 2011;15:203-6 pubmed publisher
    ..4 [1.8-7.0] vs. 2.3 [1.3-3.3] µM, P=0.003). We observed similar trends among diabetic HD patients. Whole-blood analysis by the SPF method seems to be a promising way of monitoring platelet function for HD patients...
  16. Vanholder R, Schepers E, Pletinck A, Neirynck N, Glorieux G. An update on protein-bound uremic retention solutes. J Ren Nutr. 2012;22:90-4 pubmed publisher
    ..Results from large randomized trials are awaited, before these data can be considered as solid enough to warrant the recommendation to use these compounds for overall therapeutic purposes...
  17. Weichhart T, Kopecky C, Kubicek M, Haidinger M, Döller D, Katholnig K, et al. Serum amyloid A in uremic HDL promotes inflammation. J Am Soc Nephrol. 2012;23:934-47 pubmed publisher
    b>Uremia impairs the atheroprotective properties of HDL, but the mechanisms underlying why this occurs are unknown...
  18. Chiang C, Tanaka T, Nangaku M. Dysregulated oxygen metabolism of the kidney by uremic toxins: review. J Ren Nutr. 2012;22:77-80 pubmed publisher
    ..Studies of uremic toxins will open a new avenue in development of novel therapeutic approaches of kidney disease...
  19. Brunet P, Gondouin B, Duval Sabatier A, Dou L, Cerini C, Dignat George F, et al. Does uremia cause vascular dysfunction?. Kidney Blood Press Res. 2011;34:284-90 pubmed publisher
    Vascular dysfunction induced by uremia has 4 main aspects. (1) Atherosclerosis is increased. Intima-media thickness is increased, and animal studies have established that uremia accelerates atherosclerosis...
  20. Jaisson S, Gorisse L, Pietrement C, Gillery P. Quantification of plasma homocitrulline using hydrophilic interaction liquid chromatography (HILIC) coupled to tandem mass spectrometry. Anal Bioanal Chem. 2012;402:1635-41 pubmed publisher
    ..10 ± 0.50 ?mol/mol amino acids (p < 0.001). In conclusion, this method exhibits good analytical performances and meets the criteria of sensitivity suitable for HCit concentration assessment in plasma samples...
  21. Miyamoto Y, Watanabe H, Otagiri M, Maruyama T. New insight into the redox properties of uremic solute indoxyl sulfate as a pro- and anti-oxidant. Ther Apher Dial. 2011;15:129-31 pubmed publisher
    ..These findings provide new insights into the dual role of indoxyl sulfate, which appears to be concentration-dependent, with respect to its pro- or anti-oxidative properties...
  22. Yang M, Gan H, Shen Q, Tang W, Du X, Chen D. Proinflammatory CD14+CD16+ monocytes are associated with microinflammation in patients with type 2 diabetes mellitus and diabetic nephropathy uremia. Inflammation. 2012;35:388-96 pubmed publisher
    ..expression of Toll-like receptor 4 (TLR4) and CD14(+)CD16(+) monocytes in patients with T2DM and DN patients with uremia and TLR4 response to lipopolysaccharide (LPS), and to further explore the potential effects of inflammatory immune ..
  23. Barazzoni R, Gortan Cappellari G, Zanetti M, Guarnieri G. Ghrelin and muscle metabolism in chronic uremia. J Ren Nutr. 2012;22:171-5 pubmed publisher
    ..Clinical trials of ghrelin administration are needed to test the hypothesis that ghrelin may chronically improve nutritional status and outcome in CKD patients...
  24. Giannaki C, Sakkas G, Karatzaferi C, Hadjigeorgiou G, Lavdas E, Liakopoulos V, et al. Evidence of increased muscle atrophy and impaired quality of life parameters in patients with uremic restless legs syndrome. PLoS ONE. 2011;6:e25180 pubmed publisher
    ..In contrast, there were no significant differences between groups in any of the physical performance tests, body and muscle composition...
  25. Goto S, Yoshiya K, Kita T, Fujii H, Fukagawa M. Uremic toxins and oral adsorbents. Ther Apher Dial. 2011;15:132-4 pubmed publisher
    ..Oral adsorbents are thus one of the important modalities in the treatment of uremic syndrome...
  26. Aronov P, Luo F, Plummer N, Quan Z, Holmes S, Hostetter T, et al. Colonic contribution to uremic solutes. J Am Soc Nephrol. 2011;22:1769-76 pubmed publisher
    ..These results suggest that colonic microbes may produce an important portion of uremic solutes, most of which remain unidentified...
  27. Libetta C, Sepe V, Esposito P, Galli F, Dal Canton A. Oxidative stress and inflammation: Implications in uremia and hemodialysis. Clin Biochem. 2011;44:1189-98 pubmed publisher
  28. Jourde Chiche N, Dou L, Cerini C, Dignat George F, Brunet P. Vascular incompetence in dialysis patients--protein-bound uremic toxins and endothelial dysfunction. Semin Dial. 2011;24:327-37 pubmed publisher
    ..Endothelial damage induced by a uremic environment suggests an involvement of uremia-specific factors...
  29. Carracedo J, Buendia P, Merino A, Soriano S, Esquivias E, Martin Malo A, et al. Cellular senescence determines endothelial cell damage induced by uremia. Exp Gerontol. 2013;48:766-73 pubmed publisher
    ..However, the extent to which endothelial damage induced by uremia is modulated by aging is poorly known...
  30. Zawada A, Rogacev K, Hummel B, Grün O, Friedrich A, Rotter B, et al. SuperTAG methylation-specific digital karyotyping reveals uremia-induced epigenetic dysregulation of atherosclerosis-related genes. Circ Cardiovasc Genet. 2012;5:611-20 pubmed publisher
    ..We hypothesized that gene-specific epigenetic dysregulation in CKD exists, affecting genes pertinent to inflammation and atherosclerosis...
  31. Kooman J, Broers N, Usvyat L, Thijssen S, van der Sande F, Cornelis T, et al. Out of control: accelerated aging in uremia. Nephrol Dial Transplant. 2013;28:48-54 pubmed publisher
    ..Both the phenotype of patients with ESRD as well as the pathophysiology of uremia show interesting parallels with the general aging process...
  32. Pagonas N, Vautz W, Seifert L, Slodzinski R, Jankowski J, Zidek W, et al. Volatile organic compounds in uremia. PLoS ONE. 2012;7:e46258 pubmed publisher
    Although "uremic fetor" has long been felt to be diagnostic of renal failure, the compounds exhaled in uremia remain largely unknown so far...
  33. Zaidi N, Ahmad E, Rehan M, Rabbani G, Ajmal M, Zaidi Y, et al. Biophysical insight into furosemide binding to human serum albumin: a study to unveil its impaired albumin binding in uremia. J Phys Chem B. 2013;117:2595-604 pubmed publisher
    ..But transport of various drugs like a diuretic, furosemide (FUR), via albumin in uremia is seriously compromised due to accumulation of uremic toxins...
  34. Golab F, Kadkhodaee M, Xu J, Soleimani M. Male susceptibility to hepatic damage in acute uremia in rats. Urology. 2011;78:232.e1-6 pubmed publisher
    ..evaluate the role of gender in hepatic oxidative stress response and production of inflammatory cytokines in acute uremia after bilateral nephrectomy...
  35. Vaziri N, Pahl M, Crum A, Norris K. Effect of uremia on structure and function of immune system. J Ren Nutr. 2012;22:149-56 pubmed publisher
    ..This is coupled with immune deficiency that is caused by depletion of dendritic cells, naïve and central memory T cells and B cells, and impaired phagocytic function of polymorphonuclear leukocytes and monocytes...
  36. Watanabe H, Miyamoto Y, Otagiri M, Maruyama T. Update on the pharmacokinetics and redox properties of protein-bound uremic toxins. J Pharm Sci. 2011;100:3682-95 pubmed publisher
    ..Unfortunately, despite the massive amount of information on the undesirable effects of uremic toxins, methods for improving the detoxification of these toxins appear to be lacking...
  37. Ko M, Yang J, Wu H, Hu F, Chen S, Tsai P, et al. Narrowband ultraviolet B phototherapy for patients with refractory uraemic pruritus: a randomized controlled trial. Br J Dermatol. 2011;165:633-9 pubmed publisher
    ..Pruritus is very common in uraemic patients, but the treatment remains challenging. Studies regarding narrowband ultraviolet B (NB-UVB) phototherapy for uraemic pruritus are rare...
  38. Levey A, Coresh J. Chronic kidney disease. Lancet. 2012;379:165-80 pubmed publisher
    ..In this Seminar we discuss disease burden, recommendations for assessment and management, and future challenges. We emphasise clinical practice guidelines, clinical trials, and areas of uncertainty...
  39. Zhang L, Dai Y, Wang L, Peng W, Zhang Y, Ou Y, et al. CpG array analysis of histone H3 lysine 4 trimethylation in peripheral blood mononuclear cells of uremia patients. DNA Cell Biol. 2011;30:179-86 pubmed publisher
    Studies of the epigenome have attracted little interest in nephrology, especially in uremia. Several lines of evidence have suggested that there are links between genomic DNA hypomethylation and cardiovascular complications in uremia ..
  40. Cohen G, Glorieux G, Thornalley P, Schepers E, Meert N, Jankowski J, et al. Review on uraemic toxins III: recommendations for handling uraemic retention solutes in vitro--towards a standardized approach for research on uraemia. Nephrol Dial Transplant. 2007;22:3381-90 pubmed
  41. Almeras C, Argiles A. The general picture of uremia. Semin Dial. 2009;22:329-33 pubmed publisher
    The clinical presentation and manifestations of uremia that constitute the uremic syndrome are presented...
  42. Rhee E, Souza A, Farrell L, Pollak M, Lewis G, Steele D, et al. Metabolite profiling identifies markers of uremia. J Am Soc Nephrol. 2010;21:1041-1051 pubmed publisher
    ..In summary, this study demonstrates the application of metabolite profiling to identify markers of ESRD, provide perspective on uremic dyslipidemia, and broaden our understanding of the biochemical effects of hemodialysis...
  43. Giannaki C, Sakkas G, Hadjigeorgiou G, Karatzaferi C, Patramani G, Lavdas E, et al. Non-pharmacological management of periodic limb movements during hemodialysis session in patients with uremic restless legs syndrome. ASAIO J. 2010;56:538-42 pubmed publisher
    ..Independent of intensity, a single bout of intradialytic exercise reduces PLM/hHD in hemodialysis patients with RLS. Further research is needed to establish the acute role of exercise in ameliorating the RLS symptoms...
  44. Cheung W, Kuo H, Markison S, Chen C, Foster A, Marks D, et al. Peripheral administration of the melanocortin-4 receptor antagonist NBI-12i ameliorates uremia-associated cachexia in mice. J Am Soc Nephrol. 2007;18:2517-24 pubmed
    We have recently shown that genetic or pharmacological blockade of the melanocortin-4 receptor (MC4-R) attenuates uremia-associated cachexia...
  45. Jourde Chiche N, Dou L, Sabatier F, Calaf R, Cerini C, Robert S, et al. Levels of circulating endothelial progenitor cells are related to uremic toxins and vascular injury in hemodialysis patients. J Thromb Haemost. 2009;7:1576-84 pubmed publisher
    ..CKD patients have reduced numbers of endothelial progenitor cells, but little is known about the factors influencing these numbers...
  46. Meert N, Eloot S, Waterloos M, Van Landschoot M, Dhondt A, Glorieux G, et al. Effective removal of protein-bound uraemic solutes by different convective strategies: a prospective trial. Nephrol Dial Transplant. 2009;24:562-70 pubmed publisher
  47. Hayden M, Goldsmith D, Sowers J, Khanna R. Calciphylaxis: calcific uremic arteriolopathy and the emerging role of sodium thiosulfate. Int Urol Nephrol. 2008;40:443-51 pubmed publisher
    ..Indeed, as with any new treatment this emerging therapy should be studied in greater detail, but this old drug seems to have a new life in the hands of treating physicians...
  48. Cohen G, Raupachova J, Wimmer T, Deicher R, Horl W. The uraemic retention solute para-hydroxy-hippuric acid attenuates apoptosis of polymorphonuclear leukocytes from healthy subjects but not from haemodialysis patients. Nephrol Dial Transplant. 2008;23:2512-9 pubmed publisher
  49. Goux A, Feillet Coudray C, Jover B, Fouret G, Bargnoux A, Cassan C, et al. NADPH oxidase activity is associated with cardiac osteopontin and pro-collagen type I expression in uremia. Free Radic Res. 2011;45:454-60 pubmed publisher
    ..This study aimed to investigate the role of oxidative stress in uremia-induced cardiopathy in an experimental CKD model...
  50. Herget Rosenthal S, Glorieux G, Jankowski J, Jankowski V. Uremic toxins in acute kidney injury. Semin Dial. 2009;22:445-8 pubmed publisher
    ..These uremic toxins may insofar be specific mediators of pathophysiological processes in AKI...
  51. Chen Y, Biada J, Sood S, Rabkin R. Uremia attenuates growth hormone-stimulated insulin-like growth factor-1 expression, a process worsened by inflammation. Kidney Int. 2010;78:89-95 pubmed publisher
    Growth hormone (GH) resistance is common in uremia and together with resistance to insulin-like growth factor-1 (IGF-1) contributes to uremic growth retardation and muscle wasting...
  52. Guarnieri G, Zanetti M, Vinci P, Cattin M, Barazzoni R. Insulin resistance in chronic uremia. J Ren Nutr. 2009;19:20-4 pubmed publisher
    Insulin resistance often characterizes chronic uremia, and is associated with enhanced morbidity and mortality, because it may contribute to protein-energy wasting (in turn, an independent predictor of reduced survival), atherosclerosis, ..
  53. Thornalley P, Rabbani N. Protein damage in diabetes and uremia--identifying hotspots of proteome damage where minimal modification is amplified to marked pathophysiological effect. Free Radic Res. 2011;45:89-100 pubmed publisher
    ..The role of mathematical systems biology, bioinformatics and proteome dynamics in future investigations is discussed...