Premature cardiovascular disease in chronic renal failure (CRF): A model for an advanced ageing process

Ageing leads to a decline in renal function that becomes obvious in individuals with hypertension, vascular disease, or diabetes mellitus. In the absence of such precipitating factors old age induces a reduction of renal functional reserve. It is well known that even modest declines in renal excretory function enhance the cardiovascular risk of the patient by means of myocardial remodelling, arteriosclerosis and atherosclerosis. An important non-traditional risk factor for vascular disease is chronic inflammation. Patients with renal dysfunction tend to have systemic inflammatory activation even in the absence of infection. Subclinical inflammation might be related to cellular senescence mechanisms in leukocytes that are fostered by renal insufficiency. This effect as well as enhanced oxidative stress resemble typical characteristics of both advanced ageing and renal failure. Facing these similarities, chronic renal failure might be a model that allows investigation of accelerated ageing in the vascular system.