Oxidative stress, inflammation and cardiovascular disease in chronic renal failure.
Traditional risk factors such as hypertension, diabetes, dyslipidemia, obesity and metabolic syndrome, as well as additional nontraditional risk factors, can damage the kidney directly and by promoting intrarenal atherogenesis. Evidence indicates that increased oxidative stress and inflammation may mediate most of the effects of risk factors on the kidney. Clinical studies have demonstrated a relationship between oxidative stress and inflammatory biomarkers, and a few studies indicate an inverse correlation of oxidative stress biomarkers with estimated glomerular filtration rate (eGFR). Further, surrogate indexes of atherosclerosis such as intima-media thickness and aortic pulse wave velocity have been demonstrated to be related to plasma concentrations of markers of endothelial activation, inflammation and fibrosis in patients with different stages of chronic kidney disease (CKD). Moreover, plasma concentrations of high-sensitivity C-reactive protein have been shown to be increased and related to left ventricular mass in CKD individuals having left ventricular hypertrophy. In contrast, in these patients, decreases in fetuin-A plasma levels have been reported. Considering the complex background of the pathophysiological changes characterizing CKD patients, we can consider cardiovascular disease a multifactorial complication of CKD.
Cottone
Santina
S
Chair of Nephrology and Unit of Renal Diseases and Hypertension, University of Palermo, Palermo, Italy. sancott@tin.it
Lorito
Maria Carmela
MC
Riccobene
Raffaella
R
Nardi
Emilio
E
Mulè
Giuseppe
G
Buscemi
Silvio
S
Geraci
Calogero
C
Guarneri
Marco
M
Arsena
Rosalia
R
Cerasola
Giovanni
G
D050197:Atherosclerosis / Q000209:etiology / Q000503:physiopathology; D002318:Cardiovascular Diseases / Q000209:etiology* / Q000378:metabolism / Q000503:physiopathology*; D006801:Humans; D007249:Inflammation; D007668:Kidney / Q000503:physiopathology; D007676:Kidney Failure, Chronic / Q000150:complications* / Q000378:metabolism / Q000503:physiopathology; D018384:Oxidative Stress