Novel targets and new potential: developments in the treatment of inflammation in chronic kidney disease.
BACKGROUND
Patients with chronic kidney disease (CKD) of all stages experience extremely high mortality, with cardiovascular causes accounting for about half of all their deaths. Traditional risk factors such as hypertension, hypercholesterolemia and diabetes mellitus cannot explain the excessively high cardiovascular mortality in CKD. Chronic inflammation is one of the novel risk factors that appear to contribute to the increased mortality seen in patients with CKD. Therapeutic interventions targeting chronic inflammation in CKD may lead to improved outcomes.


OBJECTIVE
To describe the role of inflammation in CKD and to review anti-inflammatory pharmacologic therapies that could have a role in its therapy.


METHODS
A review of the literature was carried out and expert opinion expressed.


CONCLUSIONS
Inflammation is a common and significant problem in CKD. There are currently no approved pharmacologic anti-inflammatory therapies in CKD but several agents are being studied in early clinical trials, while others could become viable alternatives in the future.
Kovesdy
Csaba P
CP
Salem VAMC (111D), 1970 Roanoke Blvd., Salem, VA 24153, USA. csaba.kovesdy@va.gov
Kalantar-Zadeh
Kamyar
K
D000893:Anti-Inflammatory Agents / Q000494:pharmacology / Q000627:therapeutic use*; D001402:B-Lymphocytes / Q000187:drug effects; D002318:Cardiovascular Diseases / Q000209:etiology* / Q000276:immunology / Q000401:mortality / Q000517:prevention & control; D015195:Drug Design; D015507:Drugs, Investigational / Q000494:pharmacology / Q000627:therapeutic use*; D006801:Humans; D007375:Interleukin-1 / Q000037:antagonists & inhibitors; D019409:Interleukin-15 / Q000037:antagonists & inhibitors; D020382:Interleukin-18 / Q000037:antagonists & inhibitors; D008213:Lymphocyte Activation / Q000187:drug effects; D009393:Nephritis / Q000150:complications / Q000188:drug therapy* / Q000209:etiology / Q000276:immunology / Q000401:mortality; D051436:Renal Insufficiency, Chronic / Q000150:complications* / Q000188:drug therapy / Q000276:immunology / Q000401:mortality; D012307:Risk Factors; D016896:Treatment Outcome; D014409:Tumor Necrosis Factor-alpha / Q000037:antagonists & inhibitors
D000893:Anti-Inflammatory Agents; D015507:Drugs, Investigational; D007375:Interleukin-1; D019409:Interleukin-15; D020382:Interleukin-18; D014409:Tumor Necrosis Factor-alpha