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Titolo:
The microinflammatory state in uremia: Causes and potential consequences
Autore:
Kaysen, GA;
Indirizzi:
Univ Calif Davis, Div Nephrol, Dept Med, Davis, CA 95616 USA Univ Calif Davis Davis CA USA 95616 ephrol, Dept Med, Davis, CA 95616 USA Dept Vet Affairs No Calif Hlth Care Syst, Mather, CA USA Dept Vet Affairs No Calif Hlth Care Syst Mather CA USA t, Mather, CA USA
Titolo Testata:
JOURNAL OF THE AMERICAN SOCIETY OF NEPHROLOGY
fascicolo: 7, volume: 12, anno: 2001,
pagine: 1549 - 1557
SICI:
1046-6673(200107)12:7<1549:TMSIUC>2.0.ZU;2-L
Fonte:
ISI
Lingua:
ENG
Soggetto:
CHRONIC-RENAL-FAILURE; ACUTE-PHASE PROTEINS; LOW-DENSITY-LIPOPROTEIN; IN-VITRO HEMODIALYSIS; NECROSIS-FACTOR-ALPHA; C-REACTIVE PROTEIN; OXIDATIVE STRESS; PERITONEAL-DIALYSIS; LIPID-PEROXIDATION; ENDOTHELIAL-CELLS;
Tipo documento:
Review
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Life Sciences
Citazioni:
85
Recensione:
Indirizzi per estratti:
Indirizzo: Kaysen, GA Univ Calif Davis, Div Nephrol, Dept Med, TB 136, Davis, CA 95616 USA Univ Calif Davis TB 136 Davis CA USA 95616 Davis, CA 95616 USA
Citazione:
G.A. Kaysen, "The microinflammatory state in uremia: Causes and potential consequences", J AM S NEPH, 12(7), 2001, pp. 1549-1557

Abstract

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

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 04/07/20 alle ore 14:06:01