Middle Molecular Uremic Toxin and Blood Purification Therapy

Abstract

The purpose of blood purification therapy is to remove uremic toxins, and middle molecules (MMs) are a specific target. An MM is defined as a solute that passes through the glomerulus with a molecular weight in the range of 0.5–58 kDa, and new classifications of “small-middle 0.5–15 kDa,” “medium-middle 15–25 kDa,” and “large-middle 25–58 kDa” were proposed. In Japan, the removal of α1-microglobulin (αMG) in the large-middle range has been the focus, but a new theory of removal has been developed, emphasizing the antioxidant effect of αMG as a physiological function. Clinical proof of this mechanism will lead to further development of blood purification therapies.

Keywords

• blood purification
• middle molecules
• hemodiafiltration
• MCO-membrane
• α1-microglobulin