The issue relating to several conditions such as malnutrition, disorders of body
fluid status, insulin resistance, pathological changes in peripheral nervous system, bone
mineral disorders, left ventricular hypertrophy, hypertension refractory, chronic systemic
inflammation, and the rapid decline of residual renal function in patients with regular
hemodialysis is still relatively high. Previous studies show that the above conditions are
related to uremic toxins in the body that is closely linked to the level of clearance of
uremic toxins by dialysis technique. The European Uremic Toxin Work Group (EUTox),
identifies and determines uremic toxins and its biological influences on the body. The
group found 90 types of uremic toxins and divides it into water soluble uremic toxins,
protein bound uremic toxins and middle molecular weight uremic toxins (middle
molecules). 68 (Sixty eight) are uremic toxins of small molecular weight (500 Dalton). Of the 22 medium
molecular weight uremic toxins, there are 12 (twelve) types of uremic toxins with high
molecular weight (>1,200 Dalton) and 25 (twenty five) are protein bound (Vanholder et
al 2003, Cohen et al 2007).