Skip to main content

Thank you for visiting nature.com. You are using a browser version with limited support for CSS. To obtain the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in Internet Explorer). In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript.

  • News & Views
  • Published:

Dialysis

Small solute uraemic toxin generation and adequacy of dialysis

A new paper by Sridharan and colleagues compares the roles of energy metabolism, body composition and energy expenditure in determining uraemic toxin generation in patients on haemodialysis. The researchers conclude that these factors have an important role in the generation of small solute uraemic toxins and may influence minimum dialysis requirements.

This is a preview of subscription content, access via your institution

Access options

Buy this article

Prices may be subject to local taxes which are calculated during checkout

References

  1. Gotch, F. A. & Sargent, J. A. A mechanistic analysis of the National Cooperative Dialysis Study (NCDS). Kidney Int. 28, 526–534 (1985).

    Article  CAS  Google Scholar 

  2. Port, F. K. et al. Dialysis dose and body mass index are strongly associated with survival in hemodialysis patients. J. Am. Soc. Nephrol. 13, 1061–1066 (2002).

    PubMed  Google Scholar 

  3. Sridharan, S., Vilar, E., Berdeprado, J. & Farrington, K. Energy metabolism, body composition, and urea generation rate in hemodialysis patients. Hemodial. Int. http://dx.doi.org/10.1111/hdi.12034.

  4. Depner, T. et al. Dialysis dose and the effect of gender and body size on outcome in the HEMO Study. Kidney Int. 65, 1386–1394 (2004).

    Article  Google Scholar 

  5. Flythe, J. E., Curhan, G. C. & Brunelli, S. M. Shorter length dialysis sessions are associated with increased mortality, independent of body weight. Kidney Int. 83, 104–113 (2013).

    Article  Google Scholar 

  6. Chertow, G. M. et al. In-center hemodialysis six times per week versus three times per week. N. Engl. J. Med. 363, 2287–2300 (2010).

    Article  CAS  Google Scholar 

  7. Eloot, S., Van, B. W. & Vanholder, R. A sad but forgotten truth: the story of slow-moving solutes in fast hemodialysis. Semin. Dial. 25, 505–509 (2012).

    Article  Google Scholar 

  8. Dobre, M., Meyer, T. W. & Hostetter, T. H. Searching for uremic toxins. Clin. J. Am. Soc. Nephrol. 8, 322–327 (2013).

    Article  CAS  Google Scholar 

  9. Susantitaphong, P. et al. Effect of frequent or extended hemodialysis on cardiovascular parameters: a meta-analysis. Am. J. Kidney Dis. 59, 689–699 (2012).

    Article  Google Scholar 

  10. Maduell, F. et al. High-efficiency postdilution online hemodiafiltration reduces all-cause mortality in hemodialysis patients. J. Am. Soc. Nephrol. 24, 487–497 (2013).

    Article  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Ethics declarations

Competing interests

The author declares competing interests with the following companies: Amgen (consultant, grant/research support), Baxter Healthcare (consultant) and Merck, Sharp & Dohme (consultant).

Rights and permissions

Reprints and permissions

About this article

Cite this article

ter Wee, P. Small solute uraemic toxin generation and adequacy of dialysis. Nat Rev Nephrol 9, 374–376 (2013). https://doi.org/10.1038/nrneph.2013.103

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1038/nrneph.2013.103

Search

Quick links

Nature Briefing

Sign up for the Nature Briefing newsletter — what matters in science, free to your inbox daily.

Get the most important science stories of the day, free in your inbox. Sign up for Nature Briefing