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Genomic Damage in Endstage Renal Disease—Contribution of Uremic Toxins
Institute of Pharmacology and Toxicology, University of Würzburg, Versbacher Straße 9, 97078 Würzburg, Germany
Department of Internal Medicine, University of Würzburg, Josef-Schneider-Straße 2, 97080 Würzburg, Germany
* Author to whom correspondence should be addressed.
Received: 27 August 2010; in revised form: 23 September 2010 / Accepted: 26 September 2010 / Published: 11 October 2010
Abstract: Patients with end-stage renal disease (ESRD), whether on conservative, peritoneal or hemodialysis therapy, have elevated genomic damage in peripheral blood lymphocytes and an increased cancer incidence, especially of the kidney. The damage is possibly due to accumulation of uremic toxins like advanced glycation endproducts or homocysteine. However, other endogenous substances with genotoxic properties, which are increased in ESRD, could be involved, such as the blood pressure regulating hormones angiotensin II and aldosterone or the inflammatory cytokine TNF-a. This review provides an overview of genomic damage observed in ESRD patients, focuses on possible underlying causes and shows modulations of the damage by modern dialysis strategies and vitamin supplementation.
Keywords: dialysis; genotoxicity; uremic toxins
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Schupp, N.; Heidland, A.; Stopper, H. Genomic Damage in Endstage Renal Disease—Contribution of Uremic Toxins. Toxins 2010, 2, 2340-2358.
Schupp N, Heidland A, Stopper H. Genomic Damage in Endstage Renal Disease—Contribution of Uremic Toxins. Toxins. 2010; 2(10):2340-2358.
Schupp, Nicole; Heidland, August; Stopper, Helga. 2010. "Genomic Damage in Endstage Renal Disease—Contribution of Uremic Toxins." Toxins 2, no. 10: 2340-2358.