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Seminars in Dialysis 2009Dinucleoside polyphosphates constitute a group of endogenous vasoregulatory purines and pyrimidines with a strong impact on physiologic and pathophysiologic processes of... (Review)
Review
Dinucleoside polyphosphates constitute a group of endogenous vasoregulatory purines and pyrimidines with a strong impact on physiologic and pathophysiologic processes of the cardiovascular system. Recently, the importance of dinucleoside polyphosphates in chronic kidney disease (CKD) and uremia gained increasing interest. Although our knowledge about the impact of dinucleoside polyphosphates in CKD and uremia is just at the beginning, this article reviews the current knowledge of the physiologic and pathophysiologic role of dinucleoside polyphosphates in CKD and uremia.
Topics: Dinucleoside Phosphates; Humans; Uremia
PubMed: 19708989
DOI: 10.1111/j.1525-139X.2009.00588.x -
Seminars in Dialysis 2009The clinical presentation and manifestations of uremia that constitute the uremic syndrome are presented. The first descriptions of patients with advanced or "terminal"... (Review)
Review
The clinical presentation and manifestations of uremia that constitute the uremic syndrome are presented. The first descriptions of patients with advanced or "terminal" renal failure who were treated with hemodialysis are evoked to illustrate the wide range of signs and symptoms that are associated even to a moderate decrease in renal function, presently referred to as chronic kidney disease (CKD) stages 3-4. The kidney is a central organ guaranteeing the maintenance of the "milieu intérieur," where all the cells of the body are generated, develop, proliferate, and die. Chronic kidney disease, by altering the "milieu intérieur," may alter the metabolism of every type of cell or organ, leading to a wide scope of symptoms. The most frequently observed signs in daily clinical practice are summarized and put into the perspective of the renal physician. Disturbances of ion and water metabolism, hypertension, cardiovascular disease, anemia, mineral and bone disorders, endocrine, inmmunologic and neurologic syndromes are described. The addition of these clinical manifestations defines and describes each uremic patient as a specific individual. The pathophysiologic mechanisms by which each of these signs and symptoms appears and the particular compounds responsible for their occurrence, are described in depth in subsequent chapters of this issue.
Topics: Humans; Uremia
PubMed: 19708976
DOI: 10.1111/j.1525-139X.2009.00575.x -
The American Journal of Medicine Jun 1970
Review
Topics: Animals; Behavior, Animal; Humans; Renal Dialysis; Urea; Uremia
PubMed: 4911880
DOI: 10.1016/s0002-9343(70)80001-8 -
Nature Reviews. Nephrology May 2019Uraemic syndrome (also known as uremic syndrome) in patients with advanced chronic kidney disease involves the accumulation in plasma of small-molecule uraemic solutes... (Review)
Review
Uraemic syndrome (also known as uremic syndrome) in patients with advanced chronic kidney disease involves the accumulation in plasma of small-molecule uraemic solutes and uraemic toxins (also known as uremic toxins), dysfunction of multiple organs and dysbiosis of the gut microbiota. As such, uraemic syndrome can be viewed as a disease of perturbed inter-organ and inter-organism (host-microbiota) communication. Multiple biological pathways are affected, including those controlled by solute carrier (SLC) and ATP-binding cassette (ABC) transporters and drug-metabolizing enzymes, many of which are also involved in drug absorption, distribution, metabolism and elimination (ADME). The remote sensing and signalling hypothesis identifies SLC and ABC transporter-mediated communication between organs and/or between the host and gut microbiota as key to the homeostasis of metabolites, antioxidants, signalling molecules, microbiota-derived products and dietary components in body tissues and fluid compartments. Thus, this hypothesis provides a useful perspective on the pathobiology of uraemic syndrome. Pathways considered central to drug ADME might be particularly important for the body's attempts to restore homeostasis, including the correction of disturbances due to kidney injury and the accumulation of uraemic solutes and toxins. This Review discusses how the remote sensing and signalling hypothesis helps to provide a systems-level understanding of aspects of uraemia that could lead to novel approaches to its treatment.
Topics: Biomarkers; Host Microbial Interactions; Humans; Renal Insufficiency, Chronic; Signal Transduction; Uremia
PubMed: 30728454
DOI: 10.1038/s41581-019-0111-1 -
Seminars in Dialysis 2009Proteomics has emerged as a powerful technology to decipher biological processes. One of the main goals of proteomics is the identification of biomarkers for diseases... (Review)
Review
Proteomics has emerged as a powerful technology to decipher biological processes. One of the main goals of proteomics is the identification of biomarkers for diseases from tissues and body fluids. However, the complexity and wide dynamic range of protein expression presents an enormous challenge. This review gives an overview of the different technologies used, their potentials and limitations, focusing on capillary electrophoresis coupled to mass spectrometry (CE-MS). CE-MS is discussed from an application point of view, evaluating its merits and vices for biomarker discovery and clinical applications in chronic kidney disease. Finally, several examples on the application of CE-MS to determine biomarkers for disease diagnosis, prognosis, and therapy evaluation are presented.
Topics: Electrophoresis, Capillary; Humans; Mass Spectrometry; Proteomics; Uremia
PubMed: 19708992
DOI: 10.1111/j.1525-139X.2009.00591.x -
Cardiovascular & Hematological... Jun 2006The uraemic syndrome is a complex condition that results from an accumulation of multiple waste compounds, combined with failure of the endocrine and homeostatic... (Review)
Review
The uraemic syndrome is a complex condition that results from an accumulation of multiple waste compounds, combined with failure of the endocrine and homeostatic functions of the kidney in end-stage chronic renal failure (CRF) patients. Recently it has become clear that uraemia is a microinflammatory condition with a significant increase in inflammation markers. Malnutrition is a common pathological condition which exacerbates cardiovascular mortality in uraemic patients. Inadequate diet and a state of persistent catabolism play major roles in uraemic malnutrition, yet the underlying mechanisms have not been completely clarified. Malnourished patients present elevated levels of circulating cytokines, further aggravating the oxidative and inflammatory characteristics of uraemia. It has been suggested that abnormalities in nitric oxide bioactivity, coupled with malnutrition and inflammation, may contribute to increased incidence of atherothrombotic events in uraemia. Amongst the earliest indications of nutritional deficiency are low concentrations of plasma amino acids, including L-arginine, the precursor for nitric oxide (NO) synthesis. Atherosclerosis is an inflammatory disorder and NO is an important mediator of inflammation. There is a close association between thrombosis and platelet aggregation, and NO is involved in all stages of platelet activation. L-arginine inhibits platelet aggregation both in vitro and in vivo, while L-NMMA (NG-monomethyl-L-arginine), an endogenous L-arginine analogue and inhibitor of NO synthase (NOS), increases platelet activation and adhesion. The majority of studies in animal models and human patients indicate that the systemic production of NO is increased in uraemia. CRF patients show reduced plasma concentration of L-arginine, and the enhancement of L-arginine transport is essential to maintain increased NO synthesis in platelets taken from these patients. The present review provides an overview of recent advances in the understanding of the association among malnutrition, chronic inflammation and the L-arginine-nitric oxide pathway in uraemic patients, and related potential interventions that could improve clinical outcome in chronic renal failure.
Topics: Animals; Arginine; Humans; Kidney Failure, Chronic; Malnutrition; Nitric Oxide; Thrombosis; Uremia
PubMed: 16787198
DOI: 10.2174/187152906777441821 -
European Journal of Heart Failure Dec 1999Left ventricular (LV) structure and function abnormalities are frequent in individuals with chronic uraemia; these disorders are at increased risk of cardiovascular and... (Review)
Review
Left ventricular (LV) structure and function abnormalities are frequent in individuals with chronic uraemia; these disorders are at increased risk of cardiovascular and overall morbidity and mortality in the pre-dialyzed population, during dialysis treatment and in renal transplant recipients. This review will attempt to summarize current knowledge of the prevalence, pathophysiological mechanisms of LV disease in chronic uraemia and to discuss useful medical strategies in this population.
Topics: Chronic Disease; Humans; Hypertrophy, Left Ventricular; Kidney Failure, Chronic; Risk Factors; Uremia; Ventricular Dysfunction, Left
PubMed: 10937946
DOI: 10.1016/s1388-9842(99)00057-4 -
Annals of the Royal College of Surgeons... Aug 1951
Topics: Uremia; Urologic Diseases
PubMed: 14857649
DOI: No ID Found -
Nephrology, Dialysis, Transplantation :... Sep 2014The term uraemic myopathy has been used loosely to describe the skeletal muscle abnormalities in uraemic patients. However, it does not fully explain the observed... (Review)
Review
The term uraemic myopathy has been used loosely to describe the skeletal muscle abnormalities in uraemic patients. However, it does not fully explain the observed abnormalities as recent research has documented a normal skeletal muscle physiology in the presence of reduced muscle force, selective structural changes and significant muscle wasting. Ageing is associated with sarcopenia (muscle wasting) and an increase in the prevalence of chronic kidney disease (CKD), which accelerates the normal physiological muscle wasting. Similar to sarcopenia, muscle wasting in uraemic patients appears to be the hallmark of the disease and its aetiology is multifactorial with hormonal, immunologic and myocellular changes, metabolic acidosis, reduced protein intake and physical inactivity. Uraemic sarcopenia presents a high probability for morbidity and mortality and consequently a high priority for muscle wasting prevention and treatment in these patients. Perhaps, the use of the term 'uraemic sarcopenia' would provide recognition by the renal community for this devastating problem. The purpose of this review is to relate the findings of the recent publications that describe abnormalities in uraemic skeletal muscle to the possible pathogenesis of muscle wasting and its consequences in patients with CKD.
Topics: Disease Progression; Humans; Muscle, Skeletal; Muscular Atrophy; Protein-Energy Malnutrition; Sarcopenia; Uremia
PubMed: 23625972
DOI: 10.1093/ndt/gft070 -
Lancet (London, England) Apr 1979
Topics: Humans; Lithium; Uremia
PubMed: 86135
DOI: 10.1016/s0140-6736(79)91305-9