Cardiovascular Problems in Peritoneal Dialysis: Inflammatory and Metabolic Perspectives

Despite successes in peritoneal dialysis technology, cardiovascular mortality remains unacceptably high. Putative strategies to reduce cardiovascular mortality in peritoneal dialysis population are currently based on our limited understanding of the pathophysiology. Research over the past few years has shown clear evidence for important mechanisms that are critically connected with the atherosclerosis cascade. These mechanisms include inflammation and metabolic disturbance in end-stage renal disease patients. This article reviews the association between inflammation, metabolic effect and cardiovascular mortality among dialysis population, and emphasizes areas that warrant further clarification. Recent published data from our group regarding the significance of hyperglycemia, insulin resistance, as well as inflammation in patients on peritoneal dialysis were highlighted. These results lead to the idea that ameliorating inflammatory state is an important goal for patients treated with peritoneal dialysis, especially for those with diabetes and impaired glucose tolerance. Whilst novel therapies to tackle inflammation and metabolic syndrome are on the horizon, we have yet to demonstrate conclusively their translation to human studies with clinical improved outcomes.

並列關鍵字

Peritoneal dialysis ； cardiovascular mortality ； hyperglycemia ； metabolic syndrome

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