Inflammation and Endothelial Dysfunction in the Initiation and Propagation of Cardiovascular Disease in Patients with Chronic Kidney Disease

Abstract

Background: There are many different theories on atherosclerosis pathophysiology. The dominant one is endothelial function disorder resulting from the existence of risk factors such as dyslipidemia, diabetes, smoking, and high blood pressure and hyperhomocysteinemia bacterial and viral infections. The inflammation is an important parameter for CKD appearance and evolution too. In this review we will summarize the most recent evidence that inflammation and endothelial dysfunction are implicated in the enhanced cardiovascular risk experienced by individuals with CKD, we will not discuss the role of dialysis or transplantation in the propagation of cardiovascular risk. Literature Review: Electronic medical databases were searched using as key - words the terms: “atherosclerosis”, “hemodialysis patient”, “end stage renal disease”, “Chronic Inflammation”, “Endothelial Dysfunction”. The search was conducted in English language. All studies referred to the correlation of the key terms were included and highlight the Inflammation and Endothelial Dysfunction in the Initiation and Propagation of Cardiovascular Disease in patients with Chronic Kidney Disease. Conclusions: The presence of enhanced CV risk in patients with CKD is well known but the mechanisms by which it occurs are less clear. The endothelium is a complex, multi-functional organ with a variety of vascular homeostatic functions and ED has been shown to result in the initiation and propagation of atherosclerosis. Causes of ED are numerous but inflammation and oxidative stress are clearly highly implicated; albuminuria (even at levels thought to be well below previous definitions of abnormal) may contribute to the inflammatory process, as might dyslipidemia (though a combination of traditional and no-traditional pathways).