尿毒症毒素新分类解读

The new classification of uremic toxins

尿毒症毒素的滞留及产生增多会引发一系列尿毒症症状,对全身多系统产生影响,导致患者生活质量下降和高死亡率。2003年欧洲尿毒症毒素(the European Uremic Toxin,EUTox)工作组根据尿毒症毒素的物理化学特性将其分为水溶性小分子化合物、蛋白结合型化合物、中分子化合物三类。随着对尿毒症溶质的新认识、来源的新数据和血液透析方法及膜材料的进展,既往的分类已经不能完全适应血液净化领域的新进展。因此,2020年11月—12月Claudio R作为大会主席召开了一次专家会议并编写了一份专家共识,提出了对尿毒症毒素定义及分类的新见解。本文详述了专家组关于尿毒症毒素的新定义及更具临床导向性的新分类的共识建议。

The increase and retention of uremic toxins in uremic patients lead to a series of symptoms and dysfunctions in the body that affect the quality of life and cause a higher mortality rate.In 2003,the European Uremic Toxin Working Group classified the uremic toxins according to their physical chemistry properties into three groups:water-soluble small molecule compounds,protein-binding compounds,and middle molecule compounds.With the novel understanding of uremic solutes and their sources and the improvement of hemodialysis methods and membrane materials,the previous classification cannot well adapt to recent progression in the field of blood purification.R.Claudio organized an expert meeting during November and December in 2020 and proposed an expert consensus,in which the definition and classification of uremic toxins are renewed.This article introduces the expert consensus on renewed definition of uremic toxins and recommends a new classification suitable to guide clinical practice.