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Molecular Research on the Pathogenesis of Uremia and Effects of Hemodialysis

A special issue of International Journal of Molecular Sciences (ISSN 1422-0067). This special issue belongs to the section "Molecular Pathology, Diagnostics, and Therapeutics".

Deadline for manuscript submissions: closed (15 April 2024) | Viewed by 3547

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Guest Editor
Department of Internal Medicine, Far Eastern Memorial Hospital, New Taipei City 220, Taiwan
Interests: chronic kidney disease; hemodialysis; uremia
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

Various molecules are involved in the detrimental processes observed during kidney function, leading to the development of uremia, which results in the kidneys failing to excrete waste and/or excessive water. In the milieu of uremia, the accumulation of various exogenous and endogenous toxins causes systemic manifestations, including cardiovascular, immunological, hematologic, metabolic, neurological, musculoskeletal, gastrointestinal, and dermatological problems.

Hemodialysis (HD) has been a practical treatment modality for kidney failure, regardless of acute kidney injury or end-stage kidney disease. During HD, a substantial amount of low-molecular-weight uremic toxins are cleared, whereas medium and large molecules are removed less efficiently. Meanwhile, the exposure of immune cells to extracorporeal circulation, including tubing and artificial kidneys, induces the expression of pro-inflammatory cytokines and worsens oxidative stress. The backfiltration of hazardous substances from dialysate to blood is also a unique phenomenon observed during HD therapy.

Thus, to elaborate on the molecular mechanisms involved in the pathogenesis of uremia is essential for the effective prevention of uremia. Additionally, to clarify the clearance and induction of biologically active molecules related to HD, therapy is necessary in order to achieve better care for HD patients and is worthy of more effort.

The Special Issue, titled “Molecular Research on the Pathogenesis of Uremia and Effects of Hemodialysis”, aims to provide a platform for the collection of the latest original and review articles covering molecular biological studies related to the pathogenesis of uremia and the effects of hemodialysis, serving as inspiring references for further research.

Best regards,

Dr. Shihping Hsu
Guest Editor

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Keywords

  • biocompatibility
  • hemodialysis
  • oxidative stress
  • uremic toxins
  • pro-inflammatory cytokines
 

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Published Papers (1 paper)

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Research

15 pages, 2342 KiB  
Article
Bioengineered Kidney Tubules Efficiently Clear Uremic Toxins in Experimental Dialysis Conditions
by João Faria, Sabbir Ahmed, Dimitrios Stamatialis, Marianne C. Verhaar, Rosalinde Masereeuw, Karin G. F. Gerritsen and Silvia M. Mihăilă
Int. J. Mol. Sci. 2023, 24(15), 12435; https://doi.org/10.3390/ijms241512435 - 4 Aug 2023
Cited by 1 | Viewed by 2866
Abstract
Patients with end-stage kidney disease (ESKD) suffer from high levels of protein-bound uremic toxins (PBUTs) that contribute to various comorbidities. Conventional dialysis methods are ineffective in removing these PBUTs. A potential solution could be offered by a bioartificial kidney (BAK) composed of porous [...] Read more.
Patients with end-stage kidney disease (ESKD) suffer from high levels of protein-bound uremic toxins (PBUTs) that contribute to various comorbidities. Conventional dialysis methods are ineffective in removing these PBUTs. A potential solution could be offered by a bioartificial kidney (BAK) composed of porous membranes covered by proximal tubule epithelial cells (PTECs) that actively secrete PBUTs. However, BAK development is currently being hampered by a lack of knowledge regarding the cytocompatibility of the dialysis fluid (DF) that comes in contact with the PTECs. Here, we conducted a comprehensive functional assessment of the DF on human conditionally immortalized PTECs (ciPTECs) cultured as monolayers in well plates, on Transwell® inserts, or on hollow fiber membranes (HFMs) that form functional units of a BAK. We evaluated cell viability markers, monolayer integrity, and PBUT clearance. Our results show that exposure to DF did not affect ciPTECs’ viability, membrane integrity, or function. Seven anionic PBUTs were efficiently cleared from the perfusion fluid containing a PBUTs cocktail or uremic plasma, an effect which was enhanced in the presence of albumin. Overall, our findings support that the DF is cytocompatible and does not compromise ciPTECs function, paving the way for further advancements in BAK development and its potential clinical application. Full article
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