[The factors that determine the manifestation of uremic poisoning during the development of chronic kidney failure].

To specify factors determining the intensity of uremic intoxication, 86 patients with chronic glomerulonephritis were examined without regard for exacerbation at different stages of chronic renal failure. Microcolumn gel chromatography was used to measure the content of medium-size molecules in the blood serum, urine, gastric and intestinal juice of the patients and 22 mongrel dogs before and after bilateral nephrectomy. It has been established that as the mass of acting nephrons decreases, the content of "medium-size" molecules in the blood serum and intestinal juice rises, being unchanged in gastric juice. At the same time the urinary clearance of the given group of substances declines. It is assumed that in stage I chronic renal failure, enhancement of the excretion of "medium-size" molecules in the proximal third of the small intestine is made for by hyperfiltration of intact nephrons. The appearance of the clinical symptomatology in stage II and III chronic renal failure is determined by intensification of absorption of uremic toxins by the intestine, associated with a fall of their urinary clearance. The necessity of early administration of the low-protein diet combined with enterosorbents is stressed.