Role of uremic toxins in exacerbating anemia in renal failure

Kidney Int Suppl. 2001 Feb;78:S67-72. doi: 10.1046/j.1523-1755.2001.59780067.x.


The anemia associated with renal failure is largely due to inappropriate erythropoietin production. There is also good evidence, however, that substances present in uremic serum can inhibit erythropoiesis, although the exact identity of these substances and the mechanism(s) by which they exert this effect remain obscure. Candidates that have been suggested to play a role in uremic inhibition of erythropoiesis include the polyamines (such as spermine, spermidine, putrescine, and cadaverine), parathyroid hormone, and some of the inflammatory cytokines. The potential role of each of these inhibitory substances is discussed in this article.

Publication types

  • Review

MeSH terms

  • Anemia / etiology*
  • Animals
  • Cytokines / blood
  • Cytokines / toxicity
  • Erythropoiesis / drug effects
  • Humans
  • In Vitro Techniques
  • Kidney Failure, Chronic / complications*
  • Parathyroid Hormone / blood
  • Parathyroid Hormone / toxicity
  • Polyamines / blood
  • Polyamines / toxicity
  • Toxins, Biological / blood*
  • Toxins, Biological / toxicity
  • Uremia / blood*
  • Uremia / complications*


  • Cytokines
  • Parathyroid Hormone
  • Polyamines
  • Toxins, Biological