Most studies on uraemic toxins have focused on disorders of enzymatic biochemistry. Recent studies to elucidate the pathogenesis of dialysis-related amyloidosis have provided new insights in progressive, irreversible protein modifications resulting from non-enzymatic biochemistry in uraemia. This paper focuses on two types of irreversible alterations of proteins: advanced glycation and lipoxidation. We investigate the causal role of various reactive carbonyl compounds (RCOs) accumulating in the serum, speculate on its clinical consequences, and discuss the therapeutic perspectives.
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