title: Cytokine dysregulation in chronic kidney disease: how can we treat it?
abstract: 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.
authors.affiliation: Divisions of Renal Medicine and Baxter Novum, Department of Clinical Science, Intervention and Technology, Karolinska Institutet, Stockholm, Sweden. juan.jesus.carrero@ki.se
authors.forename: Juan Jesus
authors.initials: JJ
authors.lastname: Carrero
authors.forename: Mahmut Ilker
authors.initials: MI
authors.lastname: Yilmaz
authors.forename: Bengt
authors.initials: B
authors.lastname: Lindholm
authors.forename: Peter
authors.initials: P
authors.lastname: Stenvinkel
mesh_terms: 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
chemical_list: D000806:Angiotensin-Converting Enzyme Inhibitors; D016207:Cytokines; D006495:Heparin, Low-Molecular-Weight; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors; D007378:Interleukins; D014807:Vitamin D