title: Targeting Immunity in End-Stage Renal Disease.
abstract: BACKGROUND
  Despite the stable incidence of end-stage renal disease (ESRD), it continues to be associated with an unacceptably high cardiovascular risk.
  
  
  CONCLUSIONS
  ESRD is characterized by enhanced oxidative stress and severe inflammation, which boost cardiovascular risk, thus increasing cardiovascular-associated mortality rate. While substantial effort has been made in the technological innovation of dialytic techniques, few significant advances have been made to reduce inflammation in patients with ESRD. Indeed, this contrasts with the extensive scientific breakthroughs made in the basic field of science in targeting inflammation. There is thus a pressing need for clinical trials to test the effect of reducing inflammation in patients with ESRD. Here, we will revisit the negative effect of ESRD on inflammation and explore the impact of enhanced inflammation on cardiovascular outcomes and survival in patients with ESRD. Finally, we will discuss the need for clinical trials that target inflammation in ESRD, as well as weigh potential disadvantages and offer novel innovative approaches. Key Message: We will try to understand why the issue of inflammation has not been successfully addressed thus far in patients with ESRD, while at the same time weighing the potential disadvantages and offering novel innovative approaches for targeting inflammation in patients with ESRD.
authors.affiliation: Nephrology Division, Bassini Hospital, Milan, Italy.
authors.forename: Ivano
authors.initials: I
authors.lastname: Baragetti
authors.forename: Basset
authors.initials: B
authors.lastname: El Essawy
authors.forename: Paolo
authors.initials: P
authors.lastname: Fiorina
mesh_terms: D000893:Anti-Inflammatory Agents / Q000627:therapeutic use*; D000975:Antioxidants / Q000627:therapeutic use; D002097:C-Reactive Protein / Q000037:antagonists & inhibitors / Q000276:immunology; D002318:Cardiovascular Diseases / Q000276:immunology / Q000401:mortality / Q000517:prevention & control*; D002986:Clinical Trials as Topic; D051056:Complement Inactivating Agents / Q000191:economics / Q000627:therapeutic use*; D003165:Complement System Proteins / Q000276:immunology; D016207:Cytokines / Q000037:antagonists & inhibitors / Q000276:immunology; D006801:Humans; D015994:Incidence; D007249:Inflammation / Q000453:epidemiology / Q000276:immunology / Q000628:therapy*; D007676:Kidney Failure, Chronic / Q000453:epidemiology / Q000276:immunology / Q000628:therapy*; D018384:Oxidative Stress / Q000187:drug effects* / Q000276:immunology; D006435:Renal Dialysis / Q000009:adverse effects; D012307:Risk Factors
chemical_list: D000893:Anti-Inflammatory Agents; D000975:Antioxidants; D051056:Complement Inactivating Agents; D016207:Cytokines; D003165:Complement System Proteins; D002097:C-Reactive Protein