The Microinflammatory State in Uremia: Causes and Potential Consequences

摘要: Mortality is markedly elevated in patients with end-stage renal disease. The leading cause of death cardiovascular Lipoprotein levels are only slightly dialysis patients, and risk inversely correlated serum cholesterol, suggesting that a process other than hyperlipidemia plays role the incidence Hypoalbuminemia, ascribed to malnutrition, has been one most powerful factors predict all-cause mortality patients. presence inflammation, as evidenced by increased specific cytokines (interleukin-6 tumor necrosis factor alpha) or acute-phase proteins (C-reactive protein amyloid A), however, found be associated vascular disease general population well also called response, additionally causes loss muscle mass changes plasma composition-decreases albumin, prealbumin, transferrin levels, malnutrition. Inflammation alters lipoprotein structure function endothelial favor atherogenesis increases concentration atherogenic serum, such fibrinogen (a). episodic. likely multifactorial include access infection, less-than-sterile dialysate, dialysate back leak, nonbiocompatible membranes addition clinically apparent infection. In addition, proinflammatory compounds, advanced glycation end products, accumulate failure, defense mechanisms against oxidative injury reduced, contributing inflammation its effect on endothelium.