Uremic Toxins

The present book contains the Proceedings of a two day Symposium on Uremic Toxins organized at the University of Ghent in Belgium. A series of guest lectures, free communications and posters have been presented. An international audience of 163 scientists from 16 nationalities listened to and discussed extensively a spectrum of topics brought forward by colleagues and researchers who worked for many years in the field of Uremic Toxins. There is a striking contrast between all the new dialysis strategies available in the work to "clean" the uremic patients and the almost non-progression of our knowledge on uremic toxins in the past decade. In this sense the symposium was felt by all participants as a new start for the research in the biochemical field of the definition of uremia. If the present volume would stimulate new work in this field in order to define uremia, or identify the uremic toxins, the purpose of the organizers would be maximally fulfilled.

Reviews all the latest basic and clinical researchfindings With contributions from leading international experts in thefield, this book is dedicated to all facets of uremic toxinsresearch, including low molecular weight solutes, protein-boundsolutes, and middle molecules. Moreover, it covers everything frombasic mass spectrometry research to the latest clinical findingsand practices. Uremic Toxins is divided into three sections: Section One, Uremic Toxins, explores the definition,classification, listing, and mass spectrometric analysis of uremictoxins Section Two, Selected Uremic Toxins, describes keyuremic toxins, explaining chemical structures, metabolism,analytical methods, plasma levels, toxicity, clinical implications,and removal methods. Among the uremic toxins covered are indoxylsulfate, asymmetric dimethylarginine, PTH, ß2-microglobulin,and AGEs Section Three, Therapeutic Removal of Uremic Toxins,describes how uremic toxins can be removed by hemodialysis,peritoneal dialysis, and oral sorbent All chapters are based on the authors' thorough review of theliterature as well as their own personal laboratory and clinicalexperience. References at the end of each chapter provide a gatewayto the literature in the field. Reviewing all the latest basic and clinical research findings,Uremic Toxins will help bench scientists in nephrologyadvance their own investigations. It will also help clinicians takeadvantage of the latest tested and proven treatments for themanagement of chronic kidney disease.

This book describes the latest research on the gut-kidney axis of ureic solutes; the toxico-pathological mechanisms of uremic toxin-induced organ failure, including kidney and cardiovascular tissue; and the preventive therapeutic strategies for uremia and related organ failure associated with kidney injuries and diseases. Retained uremic toxins cause a variety of symptoms, such as hypertension, fatigue, renal anemia, osteoporosis and neurologic impairment, which are apparent in chronic kidney disease (CKD) patients. The human gastrointestinal tract contains trillions of microorganisms, referred to as gut microbiota, which support the host metabolism by producing nutrients, such as vitamins and short-chain fatty acids. However, they also produce various harmful uremic toxins that show renal and cardiovascular toxicity, and correlate with an increased mortality in CKD patients. The composition and balance of gut microbiota are associated with the accumulation of uremic toxins and the pathophysiology of CKD, and as such are being considered for a novel therapeutic strategy.

Despite constant significant advances, cardiovascular as well as more general outcomes of hemodialysis treatment remain unsatisfactory. The introduction of innovative 'high retention onset' membranes has led to the development of a new treatment modality called 'expanded hemodialysis' (HDx), which is the focus of this book. This new therapy is likely to benefit end-stage kidney disease patients, thanks to enhanced removal of molecules retained by current dialysis techniques. HDx is simple to set up and application does not require special hardware or specific nursing skills. This book contains emerging evidence and fascinating new hypotheses on HDx. It is highly recommended for all physicians and healthcare professionals who are caring for dialysis patients and are seeking innovation and improved care solutions. It will also be of considerable interest to students and fellows.

Advances in itch research have elucidated differences between itch and pain but have also blurred the distinction between them. There is a long debate about how somatic sensations including touch, pain, itch, and temperature sensitivity are encoded by the nervous system. Research suggests that each sensory modality is processed along a fixed, direct-line communication system from the skin to the brain. Itch: Mechanisms and Treatment presents a timely update on all aspects of itch research and the clinical treatment of itch that accompanies many dermatological conditions including psoriasis, neuropathic itch, cutaneous t-cells lymphomas, and systemic diseases such as kidney and liver disease and cancer. Composed of contributions from distinguished researchers around the world, the book explores topics such as: Neuropathic itch Peripheral neuronal mechanism of itch The role of PAR-2 in neuroimmune communication and itch Mrgprs as itch receptors The role of interleukin-31 and oncostatin M in itch and neuroimmune communication Spinal coding of itch and pain Spinal microcircuits and the regulation of itch Examining new findings on cellular and molecular mechanisms, the book is a compendium of the most current research on itch, its prevalence in society, and the problems associated with treatment.

This translational text offers in-depth reviews of the metabolic and nutritional disorders that are prevalent in patients with renal disease. Chapter topics address the growing epidemic of obesity and metabolic syndrome. Each chapter integrates basic and clinical approaches, from cell biology and genetics to diagnosis, patient management and treatment. Chapters in sections 4-7 include new illustrative case reports, and all chapters emphasize key concepts with chapter-ending summaries. New features also include the latest National Kidney Foundation Clinical Practice Guidelines on Nutrition in Chronic Renal Failure, the most recent scientific discoveries and the latest techniques for assessing nutritional status in renal disease, and literature reviews on patients who receive continuous veno-venous hemofiltration with or without dialysis. Provides a common language for nephrologists, nutritionists, endocrinologists, and other interested physicians to discuss the underlying research and translation of best practices for the nutritional management and prevention of renal disease Saves clinicians and researchers time in quickly accessing the very latest details on nutritional practice as opposed to searching through thousands of journal articles Correct diagnosis (and therefore correct treatment) of renal, metabolic, and nutritional disorders depends on a strong understanding of the molecular basis for the disease - both nephrologists and nutritionists will benefit Nephrologists and nutritionists will gain insight into which treatments, medications, and diets to use based on the history, progression, and genetic make-up of a patient Case Reports will offer an added resource for fellows, nutritionists, and dieticians who need a refresher course

This concise book provides practical strategies to help nephrologists and endocrinologists correctly diagnose and treat the various forms of parathyroid disease they may encounter in the management of chronic kidney disease. Each chapter deals with various topics related to parathyroid gland anatomy and physiology, as well as diagnostic tests and their particularities in regard to chronic disease. The book highlights the range of therapies used for the treatment of secondary hyperparathyroidism, and critically analyses the latest research in the field. Providing an up-to-date review of the current literature, including innovations in both medical and surgical treatment and current indications for parathyroidectomy, this practice-oriented book is an excellent resource for nephrologists, endocrinologists, endocrine surgeons and family medicine physicians.