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Reconsidering the Lack of Urea Toxicity in Dialysis Patients
Author(s) -
Massy Ziad A.,
Pietrement Christine,
Touré Fatouma
Publication year - 2016
Publication title -
seminars in dialysis
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.899
H-Index - 78
eISSN - 1525-139X
pISSN - 0894-0959
DOI - 10.1111/sdi.12515
Subject(s) - medicine , urea , dialysis , toxicity , intensive care medicine , uremic toxins , biomarker , uremia , kidney disease , biochemistry , chemistry
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.