Characteristics and causes of immune dysfunction related to uremia and dialysis.
From the immunologic viewpoint, chronic kidney disease (CKD) is characterized by disorders of both the innate and adaptive systems, generating a complex and still not fully understood immune dysfunction. Markers of a chronically activated immune system are closely linked to several complications of CKD and represent powerful predictors for mortality in the CKD population. On the other hand, CKD patients respond poorly to vaccination and to challenges such as bacterial infection. Interestingly, the main causes of death in patients with CKD are cardiovascular and infectious diseases, both being pathologic processes closely linked to immune function. Therefore, accelerated tissue degeneration (as a consequence of chronic inflammation) and increased rate of sepsis (because of a poorly orchestrated immune response) represent the most important targets for interventions aiming to reduce mortality in CKD patients. Understanding the mechanisms behind the immune dysfunction that is peculiar to CKD generates a perspective to improve outcomes in this group of patients.
Center for Health and Biological Sciences, Pontifícia Universidade Católica do Paraná, Curitiba, Brazil.
Aline Borsato
AB
Hauser
Andréa E M
AE
Stinghen
Sawako
S
Kato
Sérgio
S
Bucharles
Carlos
C
Aita
Yukio
Y
Yuzawa
Roberto
R
Pecoits-Filho
D006801:Humans; D007249:Inflammation / Q000276:immunology*; D007676:Kidney Failure, Chronic / Q000150:complications* / Q000473:pathology / Q000628:therapy; D006435:Renal Dialysis / Q000009:adverse effects*; D014511:Uremia / Q000150:complications* / Q000473:pathology; D014808:Vitamin D Deficiency / Q000150:complications