ASN's Mission

To create a world without kidney diseases, the ASN Alliance for Kidney Health elevates care by educating and informing, driving breakthroughs and innovation, and advocating for policies that create transformative changes in kidney medicine throughout the world.

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Kidney Week

Clinical Practice Session

Revisiting "Middle Molecules": Blast from the Past

October 25, 2024 | 02:00 PM - 04:00 PM

Location: Room 6C, Convention Center

Session Description

The "middle molecule" hypothesis, formulated in the 1980s, proposed that uremic solutes with molecular weight range of 500 to 2,000 dalton caused toxicity, particularly peripheral neuropathy. The molecular weight range of this group of uremic solutes has since evolved to include large solutes such as beta-2 microglobulin and free light chains. This session reviews the group of large solutes as uremic toxins; behavior of these solutes during hemodialysis, hemodiafiltration, and peritoneal dialysis; and clinical effects of increasing the removal of large solutes.

Learning Objective(s)

  • Summarize the history and presumed uremic toxicity of large solutes
  • Describe the kinetic behavior of large solutes during hemodiafiltration and hemodialysis
  • Describe the removal of large solutes by peritoneal dialysis
  • Discuss the clinical effects of increasing the removal of large solutes

Learning Pathway(s)

  • Dialysis

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