Middle Molecules and the 7 C Factor

  • Jonas Bergström
  • Hans Jörnvall
  • Lena Zimmerman
Part of the Advances in Experimental Medicine and Biology book series (AEMB, volume 223)


Soon after Babb and Scribner in 19721 presented The Middle Molecule Hypothesis several investigators performed clinical studies in dialysis patients, designed to increase or decrease the presumed level of middle molecules (MM) in the body fluids relating these changes to the symptomatology of the patients or to the in vitro toxicity of plasma and dialysate (see references in 1). However, most of these studies were inconclusive and no direct determination of MM were performed.


High Performance Liquid Chromatography Salicylic Acid Continuous Ambulatory Peritoneal Dialysis Reverse Phase High Performance Liquid Chromatography Uremic Patient 
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  1. 1.
    A. L. Babb, P. C. Farrell, D. A. Uvelli, and B.H. Scribner, Hemodialyzer evaluation by examination of solute molecular spectra, Trans. Am. Soc. Artif. Intern. Organs 18:98 (1972).PubMedCrossRefGoogle Scholar
  2. 2.
    P. Fürst, L. Zimmerman, and J. Bergström, Determination of endogenous middle molecuels in normal and uremic body fluids. Clin. Nephrol. 5:178 (1976).Google Scholar
  3. 3.
    H. Asaba, J. Bergström, P. Fürst, R. Oulés, and L. Zimmerman, Accumulation and excretion of middle molecules. Eur. Dial. Transpl. Assoc. 13:481 (1976).Google Scholar
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    H. Asaba, A. Alvestrand, J. Bergström, P. Fürst, and V. Yahiel, Uremic middle molecules in non-dialyzed azotemic patients: relation to symptoms and clianical biochemistries. Clin. Nephrol. 17:90 (1982).PubMedGoogle Scholar
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    H. Asaba, A. Alvestrand, P. Fürst, and J. Bergström, Clinical implications of uremic middle molecules in regular hemodialysis patients. Clin. Nephrol. 19:179 (1983).PubMedGoogle Scholar
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    J. Bergström, H. Asaba, P. Fürst, and B. Lindholm, Middle molecules in chronic uremic patients treated with continuous ambulatory peritoneal dialysis. Perit. Dial. Bull. 3 (Suppl 1):S7 (1983).Google Scholar
  7. 7.
    L. Zimmerman, H. Jömvall, J. Bergström, P. Fürst, and J. Sjövall, Characterization of a double conjugate in uremic body fluids. Glucuronidated o-hydroxybenzoylglycine. Febs Letters 129:237 (1981).PubMedCrossRefGoogle Scholar
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    H. Asaba, L. Zimmerman, and J. Bergström, On drug artifacts in middle molecule analysis. Nephron 39:73 (1985).PubMedCrossRefGoogle Scholar
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    L. Zimmerman, J. Bergström, and H. Jörnvall, A method for separation of middle molecules by high performance liquid chromatography: application in studies of glucuronyl-o-hydroxyhippurate in normal and uremic subjects. Clin. Nephrol. 25:94 (1986).PubMedGoogle Scholar

Copyright information

© Plenum Press, New York 1987

Authors and Affiliations

  • Jonas Bergström
    • 1
  • Hans Jörnvall
    • 1
  • Lena Zimmerman
    • 1
  1. 1.Karolinska Institute Department of Renal MedicineHuddinge University HospitalHuddingeSweden

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