Griet Glorieux, Stéphane Burtey, Pieter Evenepoel, Joachim Jankowski, Laetitia Koppe, Rosalinde Masereeuw, Raymond Vanholder
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When kidney function is compromised, myriad metabolites and peptides - uraemic retention molecules (URMs) - accumulate in the body and compromise homeostasis. Over 150 molecules have been classified as URMs but omics approaches are revealing many more. When URMs exert pathophysiological effects and/or are associated with relevant adverse patient outcomes, they are called uraemic toxins. The origins of uraemic toxins and their contributions to post-translational modification of proteins are important current areas of research. Although most research has thus far focused on uraemic toxins, new studies have also identified URMs with the potential to counteract harmful biological changes that might thus confer a beneficial effect. To tackle the growing burden of chronic kidney disease, preventive therapeutic measures must target the disease early in its course and a balanced view of uraemic retention is needed to understand the role of URMs in kidney disease progression. Knowledge of the origin of the solutes, their kinetics, context-dependent biological profile and the involvement of transporter-mediated interorgan communication by small molecules - termed 'remote sensing and signalling' - is indispensable to facilitate the development of interventions that can promote or restore homeostasis in people with kidney dysfunction.
期刊介绍:
Nature Reviews Nephrology aims to be the premier source of reviews and commentaries for the scientific communities it serves.
It strives to publish authoritative, accessible articles.
Articles are enhanced with clearly understandable figures, tables, and other display items.
Nature Reviews Nephrology publishes Research Highlights, News & Views, Comments, Reviews, Perspectives, and Consensus Statements.
The content is relevant to nephrologists and basic science researchers.
The broad scope of the journal ensures that the work reaches the widest possible audience.