Inflammation as a risk factor and target for therapy in chronic kidney disease

Inflammation is a major driving force of the uremic phenotype. This review provides an update on inflammatory biomarkers in chronic kidney disease and possible therapeutic approaches targeting the uremic inflammatory milieu.

Single and longitudinal changes of C-reactive protein provide important outcome prediction. The uremic phenotype, which includes persistent inflammation, oxidative stress and protein energy wasting, has recently been shown to overshadow the traditional risk profile. As several small randomized controlled trials have shown that various nutritional, nonspecific immunomodulatory and targeted anticytokine interventions may have anti-inflammatory potential, future randomized control trials are needed to explore whether interventions specifically targeting inflammation will improve the dismal prognosis in end-stage renal disease.

Because circulating inflammatory markers predict outcomes in patients with end-stage renal disease, inflammation may be a logical future therapeutic target for nutritional and pharmacological interventions.