Middle Molecules as a Marker of Uremic Toxins

Abstract

In the past decade, toxic uremic solutes in the molecular range of 350–5000 daltons, so called middle molecules (mm), have received much attention, particularly with regard to determination of their chemical structure and biologic toxicity (1–5). Even though substantial proof is still incomplete, uremic toxins with mm have been increasingly identified. In recent years, several new mm compounds have been fractioned and isolated in increased amounts in uremic sera and have been found to be responsible for the clinical manifestations (6–8). The present study is to ascertain the value of quantitative analysis of mm in the evaluation of the efficacy of continuous ambulatory peritoneal dialysis (CAPD), hemodialysis (HD), sequential ultrafiltration and diffusion dialysis (SUD), hemofiltration (HF), hemoperfusion (HP) and reused hollow fiber dialysers.