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Uremic toxins are a heterogeneous group of organic compounds that accumulate in the body when kidney function is impaired. They include various small molecules, protein-bound solutes, and middle molecules that cannot be efficiently eliminated due to reduced renal clearance. These compounds are responsible for many of the clinical manifestations seen in chronic kidney disease and end-stage renal failure—including cardiovascular complications, neurological symptoms (such as uremic encephalopathy), immune dysfunction, and general systemic toxicity. The most well-studied examples include indoxyl sulfate and p-cresyl sulfate. The term “uremic toxin” does not refer to a single molecule or therapeutic target but rather encompasses dozens of chemically diverse substances with varying biological effects. Management focuses on their removal via dialysis or transplantation rather than direct pharmacological targeting. Note: The entry “Uremic toxin” is not a valid therapeutic target in the sense of being a specific receptor, enzyme, transporter, or other discrete molecular entity suitable for drug development. It represents an umbrella term for multiple toxic metabolites retained during renal insufficiency.
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