Division of Baxter Novum, Karolinska Institutet, Stockholm, Sweden.
Curr Opin Nephrol Hypertens. 2011 Nov;20(6):662-8. doi: 10.1097/MNH.0b013e32834ad504.
Inflammation is a major driving force of the uremic phenotype. This review provides an update on inflammatory biomarkers in chronic kidney disease and possible therapeutic approaches targeting the uremic inflammatory milieu.
Single and longitudinal changes of C-reactive protein provide important outcome prediction. The uremic phenotype, which includes persistent inflammation, oxidative stress and protein energy wasting, has recently been shown to overshadow the traditional risk profile. As several small randomized controlled trials have shown that various nutritional, nonspecific immunomodulatory and targeted anticytokine interventions may have anti-inflammatory potential, future randomized control trials are needed to explore whether interventions specifically targeting inflammation will improve the dismal prognosis in end-stage renal disease.
Because circulating inflammatory markers predict outcomes in patients with end-stage renal disease, inflammation may be a logical future therapeutic target for nutritional and pharmacological interventions.
炎症是尿毒症表型的主要驱动因素。本综述提供了慢性肾脏病中炎症生物标志物的最新进展，以及针对尿毒症炎症微环境的可能治疗方法。
C 反应蛋白的单次和纵向变化提供了重要的预后预测。最近的研究表明，尿毒症表型包括持续的炎症、氧化应激和蛋白质能量消耗，它已经超越了传统的风险因素。由于几项小型随机对照试验表明，各种营养、非特异性免疫调节和靶向细胞因子干预可能具有抗炎潜力，因此需要进行未来的随机对照试验，以探讨是否针对炎症的干预措施将改善终末期肾病患者的不良预后。
由于循环炎症标志物可预测终末期肾病患者的预后，因此炎症可能是营养和药物干预的合理未来治疗靶点。
