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Nephrol Dial Transplant (2004) 19: v34-v40
Nephrol Dial Transplant Vol. 19 Suppl 5 © ERA–EDTA 2004; all rights reserved

Causes and therapy of microinflammation in renal failure

Ralf Schindler

Charité-Virchow-Klinikum, Humboldt Universität zu Berlin, Berlin, Germany

Correspondence and offprint requests to: Dr Ralf Schindler, Department of Nephrology and Intensive Care Medicine, Charité-Virchow-Klinikum, Augustenburger Platz 1, D-13353 Berlin, Germany. Email: ralf.schindler{at}charite.de

Abstract

Microinflammation in renal failure has been the subject of numerous studies, but the causes of the inflammatory response in these patients are not clear. There are several potential causes and possible therapies for microinflammation, and they are discussed in this review with regard to uraemia and acidosis, heart failure and volume overload, oxidative stress and iron therapy, and bioincompatibility, especially regarding dialysis membranes. In addition, issues regarding dialysate contamination and access site infection are examined, followed by a discussion of possible drug therapy for microinflammation with angiotensin-converting enzyme inhibitors, angiotensin receptor antagonists, statins, aspirin, and antioxidants, such as vitamin E.

Keywords: cardiac failure; dialysis; drug therapy; microinflammation; oxidative stress; uraemia


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