Inflammation-Related Mechanisms in Chronic Kidney Disease Prediction, Progression, and Outcome

Abstract

Persistent, low-grade inflammation is now considered a hallmark feature of chronic kidney disease (CKD), being involved in the development of all-cause mortality of these patients. Although substantial improvements have been made in clinical care, CKD remains a major public health burden, affecting 10–15% of the population, and its prevalence is constantly growing. Due to its insidious nature, CKD is rarely diagnosed in early stages, and once developed, its progression is unfortunately irreversible. There are many factors that contribute to the setting of the inflammatory status in CKD, including increased production of proinflammatory cytokines, oxidative stress and acidosis, chronic and recurrent infections, altered metabolism of adipose tissue, and last but not least, gut microbiota dysbiosis, an underestimated source of microinflammation. In this scenario, a huge step forward was made by the increasing progression of omics approaches, specially designed for identification of biomarkers useful for early diagnostic and follow-up. Recent omics advances could provide novel insights in deciphering the disease pathophysiology; thus, identification of circulating biomarker panels using state-of-the-art proteomic technologies could improve CKD early diagnosis, monitoring, and prognostics. This review aims to summarize the recent knowledge regarding the relationship between inflammation and CKD, highlighting the current proteomic approaches, as well as the inflammasomes and gut microbiota dysbiosis involvement in the setting of CKD, culminating with the troubling bidirectional connection between CKD and renal malignancy, raised on the background of an inflammatory condition.

Comparison of Renal Effects of Ezetimibe–Statin Combination versus Statin Monotherapy: A Propensity-Score-Matched Analysis

“…Considering that proximal tubules require large amounts of energy for reabsorption processes and have abundant mitochondria, endoplasmic reticulum, and ribosomes, the reduction of oxidative stress and promotion of autophagy (or mitophagy) might play an important role in maintenance of renal function. In addition, plentiful studies have revealed an association between kidney diseases and inflammation, especially the abovementioned NLRP3 inflammasome [58][59][60][61]. We hypothesized that the renoprotective effect of ezetimibe in this study might be due to these mechanisms.…”

Inflammation and Oxidative Stress in Chronic Kidney Disease—Potential Therapeutic Role of Minerals, Vitamins and Plant-Derived Metabolites

“…Inflammation is characterized by an increase of inflammatory markers, including cytokines, acute phase proteins and adhesion molecules, in which the cells of the innate immune response system are mainly involved. Many factors contribute to the chronic inflammatory state in CKD, including the increased production of proinflammatory cytokines and oxidative stress, as well as acidosis, chronic and recurrent infections, intestinal dysbiosis and altered adipose tissue metabolism [20]. Systemic evaluation of these markers should be performed, even in early stages of the disease.…”

Mechanisms of Cardiovascular Disorders in Patients With Chronic Kidney Disease: A Process Related to Accelerated Senescence

“…In dialysis patients, the association of CRP with mortality was main at low CRP levels, the lower CRP level, the lower mortality risk (Bazeley et al, 2011). Other pro-and anti-inflammatory cytokines, including IL-10 and TNFα, may also play a role in the development of CKD-associated CVDs (Ekdahl et al, 2017;Mihai et al, 2018).…”