Adaptations in Chronic Uremia: Pathophysiologic ‘Trade-Offs’

Abstract

The view that the widespread systemic derangements seen in chronic renal failure result from retention of “toxins” is probably oversimplified. Rather, the uremic syndrome appears to reflect adaptations that, at a physiologic “price,” enable surviving nephrons to step up excretion and sustain kidney function. Understood this way, the syndrome may become subject to manipulations that can compensate for the deficits it entails.