[Mechanism of action of endotoxins in chronic renal failure]

Altogether 76 patients with terminal chronic renal failure (CRF) were examined for the intensity of endogenous intoxication and its action mechanism in blood serum. To determine the degree of intoxication, use was made of neuromuscular preparations of Rana temporaria. In order to study the action mechanism of the toxic substances of uremic genesis, a study was made of the effect of CRF patients' blood serum on the conduction of bilayer lipid membranes. All the patients underwent adequate hemodialysis with respect to nitrous residues. It is established that substances occurring in CRF patients' blood serum possess neurotoxic properties at the basis of which there lie their channel-former action on the excitable membranes of the nerve cells. The data obtained correlate well with the clinical status of the patients. The conventional programmed hemodialysis turned out ineffective in the relief of the syndrome of uremic endogenous intoxication. This confirms the role in endogenous intoxication of the substances with medium molecular weight, which are removed poorly via the common dialysis membranes.