Determinants of uraemic toxin removal

The inability to excrete a wide spectrum of toxins is one of the hallmarks of uraemia and is responsible for many of the signs and symptoms of this syndrome. Therefore, an understanding of the factors influencing uraemic toxin removal, during both the pre-dialysis and dialytic phases, is critically important. This review addresses many of these factors, which include the importance of preserved residual renal function and the effect of therapy frequency. In addition, specifically with respect to larger uraemic toxins, the importance of convection and treatment duration is discussed. All of these issues will be major considerations as new dialytic therapies for end-stage renal disease patients are developed and implemented.