Cytokine dysregulation in chronic kidney disease: how can we treat it?
As the kidney is the major site for elimination of many cytokines, the delicate equilibrium of pro-inflammatory cytokines and their inhibitors is clearly dysregulated in chronic kidney disease (CKD) patients. The consequences of the altered immune response in uremia lead to a state of persistent inflammation which is highly prevalent among CKD patients and is linked to complications such as the development of protein-energy wasting and atherosclerotic vascular disease. The present review aims at reviewing this complex orchestration of uremic cytokines beyond the well-studied interleukin-6 and tumor necrosis factor-alpha. Finally, we update our current understanding on anti-inflammatory treatment strategies in CKD patients, including nutritional and lifestyle measurements, pharmacological intervention and specific anticytokine strategies targeting the dialytic procedure.
Carrero
Juan Jesus
JJ
Divisions of Renal Medicine and Baxter Novum, Department of Clinical Science, Intervention and Technology, Karolinska Institutet, Stockholm, Sweden. juan.jesus.carrero@ki.se
Yilmaz
Mahmut Ilker
MI
Lindholm
Bengt
B
Stenvinkel
Peter
P
D000806:Angiotensin-Converting Enzyme Inhibitors / Q000627:therapeutic use; D050197:Atherosclerosis / Q000209:etiology / Q000517:prevention & control; D002908:Chronic Disease; D003131:Combined Modality Therapy; D016207:Cytokines / Q000378:metabolism*; D019468:Disease Management; D005081:Exercise Therapy; D006495:Heparin, Low-Molecular-Weight / Q000627:therapeutic use; D006706:Homeostasis / Q000276:immunology; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000627:therapeutic use; D007249:Inflammation / Q000209:etiology / Q000517:prevention & control; D007378:Interleukins / Q000378:metabolism; D007674:Kidney Diseases / Q000178:diet therapy / Q000188:drug therapy / Q000276:immunology* / Q000378:metabolism / Q000628:therapy; D008019:Life Style; D018448:Models, Immunological; D016176:T-Lymphocyte Subsets / Q000276:immunology / Q000378:metabolism; D014807:Vitamin D / Q000627:therapeutic use
D000806:Angiotensin-Converting Enzyme Inhibitors; D016207:Cytokines; D006495:Heparin, Low-Molecular-Weight; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors; D007378:Interleukins; D014807:Vitamin D