Nutrition, immunology, and renal disease

The effects of disturbances of nutrition and renal function (e.g., uremia) on immune function have been compared. The two disturbances share many common effects, and it seems likely that some of the abnormalities in cell-mediated immunity in uremia may be the result of depletion or deprivation of essential nutrients (e.g., protein, zinc, pyridoxine). Ample evidence is also available to incriminate the emergence of a family of immunoregulatory lipoproteins (and perhaps other endogenous uremic toxins) in the pathogenesis of the disordered immune function in uremia. Finally, depletion of other specific dietary constituents (e.g., calories, fatty acids, phosphate) may also have profound effects on the immunologic or mediator systems involved in the pathogenesis of glomerulonephritis. Exploitation of these dietary manipulations may permit modulation of the natural history of these diseases.