Impact de l’accumulation sérique des toxines urémiques au cours de l’insuffisance rénale aiguë

Abstract

AbstractDuring kidney injury, molecules called uremic toxins accumulate in blood. Protein-bound uremic toxins (PBUTs) are not correctly eliminated by conventional techniques of hemodialysis. Their tissue toxicity is well described during chronic kidney disease (CKD). They have specific pathological effects on cardiovascular system which are associated to patients morbi-mortality. In addition, they are correlated to CKD progression and have toxic action on neurologic and immune systems. Their concentrations also raised during acute kidney injury (AKI), even if lower than in CKD. AKI is also frequently associated with organ dysfunction during the episode and to cardiovascular events and mortality at short and long term. Moreover, in recent experimental studies, PBUTs, in particular indoxyl sulfate and para-cresyl sulfate, appear to be also responsible of acute cardiovascular, kidney and neurologic damages. However, these results need to be confirmed in clinical studies in the way to clearly determine the role of PBUTs in organ dysfunction during AKI and to evaluate their association to cardiovascular events and global mortality.