Kidney failure is associated with the retention and subsequent accumulation of uraemic toxins, which have detrimental effects on various physiological processes. The removal of these toxins by current dialysis modalities is inadequate, highlighting the need for innovative approaches to enhance their clearance and/or suppress their generation to improve outcomes for patients with kidney disease.
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References
- 1.
Chen, Y. et al. Kidney clearance of secretory solutes is associated with progression of CKD: the CRIC study. J. Am. Soc. Nephrol. 31, 817–827 (2020).
- 2.
Yen, S. C. et al. Carbon nanotube/conducting polymer hybrid nanofibers as novel organic bioelectronic interfaces for efficient removal of protein-bound uremic toxins. ACS Appl. Mater. Interfaces 11, 43843–43856 (2019).
- 3.
Krieter, D. H. et al. Haemodiafiltration at increased plasma ionic strength for improved protein-bound toxin removal. Acta Physiol. 219, 510–520 (2017).
- 4.
Madero, M. et al. Removal of protein-bound uremic toxins during hemodialysis using a binding competitor. Clin. J. Am. Soc. Nephrol. 14, 394–402 (2019).
- 5.
van Gelder, M. K. et al. Urea removal strategies for dialysate regeneration in a wearable artificial kidney. Biomaterials 234, 119735 (2020).
- 6.
Hill, K. et al. Second generation nanoporous silicon nitride membranes for high toxin clearance and small format hemodialysis. Adv. Healthc. Mater. 9, e1900750 (2020).
- 7.
Pavlenko, D. et al. Carbon adsorbents with dual porosity for efficient removal of uremic toxins and cytokines from human plasma. Sci Rep 7, 14914 (2017).
- 8.
Chen, Y. C. et al. Effects and safety of an oral adsorbent on chronic kidney disease progression: a systematic review and meta-analysis. J. Clin. Med. 8, 1718 (2019).
- 9.
Jansen, J. et al. Remote sensing and signaling in kidney proximal tubules stimulates gut microbiome-derived organic anion secretion. Proc. Natl Acad. Sci. USA 116, 16105–16110 (2019).
- 10.
Meijers, B., Evenepoel, P. & Anders, H. J. Intestinal microbiome and fitness in kidney disease. Nat. Rev. Nephrol. 15, 531–545 (2019).
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R.M. has received a grant from Gambro Dialysatoren GmbH (Baxter) for collaborative research and is a member of the ESAO/ERA-EDTA endorsed Work Group EUTox. M.C.V. declares no competing interests.
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European Uremic Toxin Work Group: http://www.uremic-toxins.org/
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Masereeuw, R., Verhaar, M.C. Innovations in approaches to remove uraemic toxins. Nat Rev Nephrol 16, 552–553 (2020). https://doi.org/10.1038/s41581-020-0299-0
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