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Published on: November 7, 2017
Inflammation in uremic patients: what is the link?
Jan Galle1, Stefan Seibold, Christoph Wanner
1Department of Medicine, Division of Nephrology, University of Würzburg, Würzburg, Germany. j-c.galle@mail.uni-wuerzburg.de
Insights
Cardiovascular disease is prevalent in uremic patients due to inflammation and oxidative stress. Targeting these factors may reduce cardiovascular risk in end-stage renal disease.
Area of Science:
- Nephrology
- Cardiology
- Biochemistry
Background:
- Uremic patients exhibit high rates of cardiovascular disease, primarily driven by arterial atherosclerotic remodeling.
- Inflammation significantly contributes to atherosclerosis development, with oxidative stress being a common pro-inflammatory factor.
Purpose of the Study:
- To review the role and predictive value of inflammation in end-stage renal disease (ESRD) patients.
- To analyze specific pro-inflammatory and pro-oxidative conditions in uremic patients.
- To discuss potential therapeutic strategies for reducing cardiovascular disease in ESRD.
Main Methods:
- Review of existing literature on inflammation, oxidative stress, and cardiovascular disease in ESRD.
- Analysis of pathophysiological mechanisms linking uremia to inflammation and oxidative stress.
- Discussion of therapeutic interventions targeting inflammation and oxidative stress.
Main Results:
- Inflammation, particularly C-reactive protein, is a known cardiovascular risk marker in the general population.
- Uremic patients face specific pro-inflammatory and pro-oxidative conditions, including those induced by modified lipoproteins and angiotensin II.
- These conditions likely contribute to the high cardiovascular disease burden in ESRD.
Conclusions:
- Inflammation and oxidative stress are critical contributors to cardiovascular disease in uremic patients.
- Understanding uremic-specific pro-inflammatory and pro-oxidative pathways is essential.
- Therapeutic strategies targeting these pathways hold promise for mitigating cardiovascular risk in ESRD.
Abstract:
Uremic patients suffer to an extremely high degree from cardiovascular disease. Cardiovascular disease results mainly from atherosclerotic remodeling of the arterial system. Inflammation is considered to contribute significantly to development of atherosclerosis, and albeit many different factors may lead to inflammation, generation of enhanced oxidative stress is believed to be an important common feature of pro-inflammatory causes. Studies in the general population without renal disease could clearly show that markers of inflammation, in particular C-reactive protein, predict the cardiovascular risk. In this review article, we discuss the presence and the predictive value of inflammation in patients with end-stage renal disease, and analyze whether uremic patients are exposed to specific pro-inflammatory and pro-oxidative conditions. Particular emphasis is set on oxidative stress induced by oxidatively modified lipoproteins and angiotensin II. Based on pathophysiological considerations valid for uremic patients, we discuss therapeutical options that might help to reduce cardiovascular disease in uremic patients.
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