Kelly Dearbhla M, Kelleher Eoin M, Rothwell Peter M
Wolfson Centre for the Prevention of Stroke and Dementia, Nuffield Department of Clinical Neurosciences (D.M.K., P.M.R.).
Nuffield Department of Clinical Neurosciences (E.M.K.), University of Oxford, United Kingdom.
Stroke. 2025 Apr;56(4):1069-1081. doi: 10.1161/STROKEAHA.124.047070. Epub 2025 Jan 24.
Cardiovascular diseases such as stroke are a major cause of morbidity and mortality for patients with chronic kidney disease (CKD). The underlying mechanisms connecting CKD and cardiovascular disease are yet to be fully elucidated, but inflammation is proposed to play an important role based on genetic association studies, studies of inflammatory biomarkers, and clinical trials of anti-inflammatory drug targets. There are multiple sources of both endogenous and exogenous inflammation in CKD, including increased production and decreased clearance of proinflammatory cytokines, oxidative stress, metabolic acidosis, chronic and recurrent infections, dialysis access, changes in adipose tissue metabolism, and disruptions in intestinal microbiota. This review focuses on the mechanisms of inflammation in CKD, dialysis and associated therapies, its proposed impact on stroke pathogenesis and prognosis, and the potential role of anti-inflammatory agents in the prevention and treatment of stroke in patients with CKD.
中风等心血管疾病是慢性肾脏病（CKD）患者发病和死亡的主要原因。连接CKD和心血管疾病的潜在机制尚未完全阐明，但基于基因关联研究、炎症生物标志物研究以及抗炎药物靶点的临床试验，炎症被认为起着重要作用。CKD存在内源性和外源性炎症的多种来源，包括促炎细胞因子产生增加和清除减少、氧化应激、代谢性酸中毒、慢性和复发性感染、透析通路、脂肪组织代谢变化以及肠道微生物群紊乱。本综述重点关注CKD、透析及相关治疗中的炎症机制、其对中风发病机制和预后的潜在影响，以及抗炎药物在CKD患者中风预防和治疗中的潜在作用。
