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Publications
Reviews
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The review and statement papers with their abstracts are listed below, in part with a direct access to their Full Paper: |
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J Am Soc Nephrol (2008)
A bench to bedside view of uremic toxins.
Vanholder R, Baurmeister U, Brunet P, Cohen G, Glorieux G, Jankowski J.
Reviewing the current picture of uremic toxicity reveals its
complexity. Focusing on cardiovascular damage as a model of uremic
effects resulting in substantial morbidity and mortality, most
molecules with potential to affect the function of a variety of cell
types within the vascular system are difficult to remove by dialysis.
Examples are the larger middle molecular weight molecules and
protein-bound molecules. Recent clinical studies suggest that enhancing
the removal of these compounds is beneficial for survival. Future
therapeutic options are discussed, including improved removal of toxins
and the search for pharmacologic strategies blocking responsible
pathophysiologic pathways. |
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Nephrol Dial Transplant; 22: 3115-3121, 2007
Review on uraemic solutes II-variability in reported concentrations: causes and consequences.
Vanholder R, Meert N, Schepers E et al.
The aim of this manuscript is to initiate a constructive discussion
about deviations in measured concentrations of uraemic solutes; these
deviations, if not perceived or handled appropriately, may lead to
incorrect interpretations of the pathophysiological role of uraemic
solutes and/or to erroneous therapeutic decisions. To come to an
objective approach towards this problem, variability analysis of
reported concentrations may be of help. Striking outliers should either
be discarded or considered together with other values which are more
consistent with the majority of reported data. |
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Nephrol Dial Transplant; 22: 3381-3390, 2007
Review on uraemic toxins III:
recommendations for handling uraemic retention solutes in
vitro--towards a standardized approach for research on uraemia.
Cohen G, Glorieux G, Thornalley P et al.
No abstract |
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Artif Organs 31: 600-611, 2007
Inconsistency of reported uremic toxin concentrations.
Meert N, Schepers E, De Smet R et al.
Discrepancies in reported uremic toxin concentrations were evaluated
for 78 retention solutes. For this analysis, 378 publications were
screened. Up to eight publications per toxin were retained. The highest
and the lowest reported concentrations, as well as the median reported
concentration were registered. The ratio between the highest and the
lowest (H/L) concentrations and, for some solutes, also the ratio
between the highest and the median (H/M) concentrations were
calculated. The compounds were arbitrarily subdivided into three groups
based on their H/L ratio: group A, H/L < 3
(n = 33); group B, 3 < H/L < 8.5
(n = 20); and group C, H/L > 8.5
(n = 25). Solutes of groups A and B showed a low to
intermediate scatter, suggesting a homogeneity of reported data. Group
C showed a more substantial scatter. For at least 10 compounds of group
C, extremely divergent concentrations were registered
(H/M > 5.5) using scatter plot analysis. For all solutes
of groups A and B, the highest reported concentration could be used as
a reference. For some solutes of group C and for the compounds showing
a divergent scatter analysis, however, more refined directives should
be followed. |
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Artif Organs. 2005 Jun;29(6):498-506.
The European artificial organ scene: present status.
Vanholder R, del Canizo JF, Sauer IM, Stegmayr B.
Nephrology Section, Department of Internal Medicine, University Hospital, Gent, Belgium . raymond.vanholder@ugent.be
This article summarizes the current evolutions regarding artificial
organs in Europe. The review emanates from the activities by four of
the work groups of the European Society for Artificial Organs (ESAO)
and is essentially based on the reports by these work groups at the
latest ESAO meeting in Warsaw, Poland (2004). The topics are:
apheresis, heart support, liver support, uremic toxins. |
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Nephrol Dial Transplant. 2005 Jun;20(6):1048-56. Epub 2005 Apr 6
Chronic kidney disease as cause of cardiovascular morbidity and mortality.
Full Paper 
Vanholder R, Massy Z, Argiles A, Spasovski G, Verbeke F, Lameire N; European Uremic Toxin Work Group.
Nephrology Section, 0K12, University Hospital, De Pintelaan 185, B-9000 Gent, Belgium. raymond.vanholder@ugent.be
To make an evidence-based evaluation of the relationship between kidney
failure and cardiovascular risk, we reviewed the literature obtained
from a PubMed search using pre-defined keywords related to both
conditions and covering 18 years (1986 until end 2003). Eighty-five
publications, covering 552 258 subjects, are summarized. All but three
studies support a link between kidney dysfunction and cardiovascular
risk. More importantly, the association is observed very early during
the evolution of renal failure: an accelerated cardiovascular risk
appears at varying glomerular filtration rate (GFR) cut-off values,
which were >/=60 ml/min in at least 20 studies. Many studies lacked
a clear definition of cardiovascular disease and/or used a single
determination of serum creatinine or GFR as an index of kidney
function, which is not necessarily corresponding to well-defined
chronic kidney disease. In six studies, however, chronic kidney
dysfunction and cardiovascular disease were well defined and the
results of these confirm the impact of kidney dysfunction. It is
concluded that there is an undeniable link between kidney dysfunction
and cardiovascular risk and that the presence of even subtle kidney
dysfunction should be considered as one of the conditions necessitating
intensive prevention of this cardiovascular risk. |
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Contrib Nephrol. 2005;149:315-24.
New insights in uremic toxicity.
Vanholder R, Glorieux G, Lameire N.
Nephrology Section, Department of Internal Medicine, University Hospital, Ghent, Belgium . raymond.vanholder@ugent.be
The uremic syndrome is characterised by the retention of a host of
compounds that in healthy subjects are secreted by the kidneys into
normal urine. These compounds disturb many physiologic functions,
resulting in toxicity. Many of the responsible compounds remain
unknown, however, as well as many patho-physiologic actions of the
known retention solutes. In this publication, we review recent new
information regarding uremic toxicity. Especially difficult to remove
compounds, such as protein bound and larger molecules, seem to play a
role. New strategies enhancing their removal might be highly useful. |
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Kidney International, Vol. 63 (2003), pp. 1934–1943
Review on uremic toxins: Classification, concentration, and interindividual variability
Full Paper
Raymond Vanholder, Rita de Smet, Griet Glorieux, Angel Argile´s,
Ulrich Baurmeister, Philippe Brunet, William Clark, Gerald Cohen, Peter
Paul de Deyn, Reinhold Deppisch, Beatrice Descamps-Latscha, Thomas
Henle, Achim Jörres, Horst Dieter Lemke, Ziad A. Massy, Jutta
Passlick-Deetjen, Mariano Rodriguez, Bernd Stegmyr, Peter Stenvinkel,
Ciro Tetta, Christoph Wanner, and Walter Zidek, for the European Uremic
Toxin Work Group (EUTOX) |
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Nephrol Dial Transplant 18:463-466, 2003
Uraemic toxins and cardiovascular disease.
Full Paper 
Vanholder R, Glorieux G, Lameire N:
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Kidney Int Suppl. Vol.63 (2003) Supl 84, :pp. 6-10
New insights in uremic toxins.
Full Paper 
Vanholder R, Glorieux G, De Smet R, Lameire N; European Uremic Toxin Work Group.
Nephrology Section, Department of Internal Medicine, University Hospital, Gent, Belgium . raymond.vanholder@rug.ac.be
The retention in the body of compounds, which normally are secreted
into the urine results in a clinical picture, called the uremic
syndrome. The retention compounds responsible for the uremic syndrome
are called uremic toxins. Only a few of the uremic retention solutes
fully conform to a true definition of uremic toxins. Uremic patients
develop atheromatotic vascular disease more frequently and earlier than
the general population. The classical risk factors seem to be less
important. Other factors have been suggested to be at play, and among
those uremic toxins are mentioned as potential culprits. The
identification, classification and characterization of the solutes
responsible for vascular problems seems of utmost importance but is far
from complete due to a lack of standardization and organization. The
European Uremic Toxin Work Group (EUTox) has as a primary aim to
discuss, analyze and offer guidelines in matters related to the
identification, characterization, analytical determination and
evaluation of biological activity of uremic retention solutes. The
final aim remains the development of new strategies to reduce the
concentration of the most active uremic solutes. These activities will
at first be concentrated on reducing factors influencing cardiovascular
morbidity and mortality. |
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Int J Artif Organs 2001 Oct;24(10):695-725
Uremic toxicity: present state of the art.
Full Paper 
Vanholder R, Argiles A, Baurmeister U, Brunet P, Clark W, Cohen G, De
Deyn PP, Deppisch R, Descamps-Latscha B, Henle T, Jorres A, Massy ZA,
Rodriguez M, Stegmayr B, Stenvinkel P, Wratten ML. Department of
Internal Medicine, University Hospital, Gent, Belgium .
raymond.vanholder@rug.ac.be
The uremic syndrome is a complex mixture of organ dysfunctions, which
is attributed to the retention of a myriad of compounds that under
normal condition are excreted by the healthy kidneys (uremic toxins).
In the area of identification and characterization of uremic toxins and
in the knowledge of their pathophysiologic importance, major steps
forward have been made during recent years. The present article is a
review of several of these steps, especially in the area of information
about the compounds that could play a role in the development of
cardiovascular complications. It is written by those members of the
Uremic Toxins Group, which has been created by the European Society for
Artificial Organs (ESAO). Each of the 16 authors has written a state of
the art in his/her major area of interest.
Reproduced with permission of Wichtig Editore Medical Publisher who copyright all contents published in The International Journal of Artificial Organs (Blue Journal). |
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