Ниркова недостатність. II. Метаболічна картина: водорозчинні уремічні токсини
Uremic syndrome results from accumulation of hydrophilic and hydrophobic toxins which in normal state are excreted by kidneys. Toxic compounds of hydrophilic nature are present in blood plasma in a free-soluble state. The content of some of such compounds serves as the main parameter of clinical state of patients with renal failure. The aim of the review is general characteristics of the main groups of water-soluble uremic toxins and detailed description of toxic effects of the most remarkable representatives of each group. Methods. In the review there is presented a retrospective analysis of literature data on water-soluble uremic toxins based on consideration of numerous reports published in the period between 1848 and 2013. Results. The article presents the description of six main groups of water-soluble uremic toxins, their general short characteristics, and the main toxic effects of some representatives of these groups. For each of these, molecular weight, the lower and upper concentration ranges observed in the case of renal insufficiency and their content in normal state are presented. Commonly used compounds - “markers” characterizing the clinical state of patients with renal dysfunction, are described in detail. Conclusion. The problem of accumulation of water-soluble uremic toxins does n’t come down just to excessive concentrations of common markers of renal failure - urea, creatinine, and uric acid. It encompasses wider spectrum of compounds requiring systemic analysis of their content in blood plasma of uremic patients. The data of review of literature point on important role of water-soluble uremic toxins in pathogenesis of uremic syndrome and a number of associated complications such as cardiovascular diseases, diabetes mellitus etc.