Systemic inflammation is a condition intrinsically linked to chronic kidney disease
(CKD) and its other typical sequelae, such as acquired immune dysfunction, protein-energy
wasting (PEW), and accelerated vascular aging that promote premature cardiovascular
disease (CVD) and infections, the two leading causes of death in CKD patients. Inflammation
is a major contributor to complications in CKD, and inflammatory markers, such as
C-reactive protein and pro- and anti-inflammatory cytokines, correlate with underlying
causes and consequences of the inflamed uremic phenotype, such as oxidative stress,
endothelial dysfunction, CVD, PEW, and infections, and are sensitive and independent
predictors of outcome in CKD. Therefore, inflammation appears to be a logical target
for potential preventive and therapeutic interventions in patients with CKD. Putative
anti-inflammatory therapy strategies aiming at preventing complications and improving
outcomes in CKD span over several areas: (1) dealing with the source of inflammation
(such as cardiovascular, gastrointestinal or periodontal disease and depression);
(2) providing nonspecific immune modulatory effects by promoting healthy dietary habits
and other lifestyle changes; (3) promoting increased use of recognized pharmacologic
interventions that have pleiotropic effects; and, (4) introducing novel targeted anticytokine
interventions. This review provides a brief update on inflammatory biomarkers and
possible therapeutic approaches targeting inflammation and the uremic inflammatory
milieu in patients with CKD.
Abbreviations:
CKD (chronic kidney disease), CRP (C-reactive protein), CV (cardiovascular), CVD (cardiovascular disease), ESRD (end-stage renal disease), HD (hemodialysis), hsCRP (high-sensitivity C-reactive protein), IL-1 (interleukin- 1), IL-6 (interleukin-6), IL-10 (interleukin-10), LPS (lipopolysaccharide), MIA (malnutrition, inflammation, atherosclerosis), Nrf2 (nuclear factor erythroid 2–related factor), PD (peritoneal dialysis), PEW (protein-energy wasting), PTX3 (pentraxin-3), PUFA (polyunsaturated fatty acid), RCT (randomized controlled trial), SFA (saturated fatty acid), TNF (tumor necrosis factor), TWEAK (TNF-like weak inducer of apoptosis)To read this article in full you will need to make a payment
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Article info
Publication history
Published online: June 24, 2015
Accepted:
June 18,
2015
Received in revised form:
June 16,
2015
Received:
April 3,
2015
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© 2016 Elsevier Inc. Published by Elsevier Inc. All rights reserved.
