title: Aspects of immune dysfunction in end-stage renal disease.
abstract: End-stage renal disease (ESRD) is associated with significantly increased morbidity and mortality resulting from cardiovascular disease (CVD) and infections, accounting for 50% and 20%, respectively, of the total mortality in ESRD patients. It is possible that these two complications are linked to alterations in the immune system in ESRD, as uremia is associated with a state of immune dysfunction characterized by immunodepression that contributes to the high prevalence of infections among these patients, as well as by immunoactivation resulting in inflammation that may contribute to CVD. This review describes disorders of the innate and adaptive immune systems in ESRD, underlining the specific role of ESRD-associated disturbances of Toll-like receptors. Finally, based on the emerging links between the alterations of immune system, CVD, and infections in ESRD patients, it emphasizes the potential role of the immune dysfunction in ESRD as an underlying cause for the high mortality in this patient population and the need for more studies in this area.
authors.affiliation: Division of Renal Medicine, Department of Clinical Science, Intervention and Technology, Karolinska Institutet, Stockholm, Sweden.
authors.forename: Sawako
authors.initials: S
authors.lastname: Kato
authors.forename: Michal
authors.initials: M
authors.lastname: Chmielewski
authors.forename: Hirokazu
authors.initials: H
authors.lastname: Honda
authors.forename: Roberto
authors.initials: R
authors.lastname: Pecoits-Filho
authors.forename: Seiichi
authors.initials: S
authors.lastname: Matsuo
authors.forename: Yukio
authors.initials: Y
authors.lastname: Yuzawa
authors.forename: Anders
authors.initials: A
authors.lastname: Tranaeus
authors.forename: Peter
authors.initials: P
authors.lastname: Stenvinkel
authors.forename: Bengt
authors.initials: B
authors.lastname: Lindholm
mesh_terms: D050197:Atherosclerosis / Q000276:immunology; D002318:Cardiovascular Diseases / Q000276:immunology* / Q000401:mortality; D003141:Communicable Diseases / Q000276:immunology* / Q000401:mortality; D006801:Humans; D007107:Immune System / Q000503:physiopathology*; D007113:Immunity, Innate; D007676:Kidney Failure, Chronic / Q000150:complications / Q000276:immunology* / Q000401:mortality; D051192:Receptors, Pattern Recognition / Q000378:metabolism; D015398:Signal Transduction / Q000276:immunology; D051193:Toll-Like Receptors / Q000378:metabolism
chemical_list: D051192:Receptors, Pattern Recognition; D051193:Toll-Like Receptors