Immune Dysfunction in Uremia—An Update

Kidney dysfunction leads to disturbed renal metabolic activities and to impaired glomerular filtration, resulting in the retention of toxic solutes affecting all organs of the body. Cardiovascular disease (CVD) and infections are the main causes for the increased occurrence of morbidity and mortalit...

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Main Authors: Gerald Cohen, Walter H. Hörl
Format: Article
Language:English
Published: MDPI AG 2012-10-01
Series:Toxins
Subjects:
Online Access:http://www.mdpi.com/2072-6651/4/11/962
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author Gerald Cohen
Walter H. Hörl
author_facet Gerald Cohen
Walter H. Hörl
author_sort Gerald Cohen
collection DOAJ
description Kidney dysfunction leads to disturbed renal metabolic activities and to impaired glomerular filtration, resulting in the retention of toxic solutes affecting all organs of the body. Cardiovascular disease (CVD) and infections are the main causes for the increased occurrence of morbidity and mortality among patients with chronic kidney disease (CKD). Both complications are directly or indirectly linked to a compromised immune defense. The specific coordinated roles of polymorphonuclear leukocytes (PMNLs), monocytes/macrophages, lymphocytes and antigen-presenting cells (APCs) in maintaining an efficient immune response are affected. Their normal response can be impaired, giving rise to infectious diseases or pre-activated/primed, leading to inflammation and consequently to CVD. Whereas the coordinated removal via apoptosis of activated immune cells is crucial for the resolution of inflammation, inappropriately high apoptotic rates lead to a diminished immune response. In uremia, the balance between pro- and anti-inflammatory and between pro- and anti-apoptotic factors is disturbed. This review summarizes the interrelated parameters interfering with the immune response in uremia, with a special focus on the non-specific immune response and the role of uremic toxins.
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spelling doaj.art-b6071e9357b34cf09c20737c6a847dc82022-12-22T02:19:56ZengMDPI AGToxins2072-66512012-10-0141196299010.3390/toxins4110962Immune Dysfunction in Uremia—An UpdateGerald CohenWalter H. HörlKidney dysfunction leads to disturbed renal metabolic activities and to impaired glomerular filtration, resulting in the retention of toxic solutes affecting all organs of the body. Cardiovascular disease (CVD) and infections are the main causes for the increased occurrence of morbidity and mortality among patients with chronic kidney disease (CKD). Both complications are directly or indirectly linked to a compromised immune defense. The specific coordinated roles of polymorphonuclear leukocytes (PMNLs), monocytes/macrophages, lymphocytes and antigen-presenting cells (APCs) in maintaining an efficient immune response are affected. Their normal response can be impaired, giving rise to infectious diseases or pre-activated/primed, leading to inflammation and consequently to CVD. Whereas the coordinated removal via apoptosis of activated immune cells is crucial for the resolution of inflammation, inappropriately high apoptotic rates lead to a diminished immune response. In uremia, the balance between pro- and anti-inflammatory and between pro- and anti-apoptotic factors is disturbed. This review summarizes the interrelated parameters interfering with the immune response in uremia, with a special focus on the non-specific immune response and the role of uremic toxins.http://www.mdpi.com/2072-6651/4/11/962cardiovascular diseaseoxidative stressinflammationinfectionprimingapoptosisuremic toxinspolymorphonuclear leukocytesmonocytesantigen-presenting cells
spellingShingle Gerald Cohen
Walter H. Hörl
Immune Dysfunction in Uremia—An Update
Toxins
cardiovascular disease
oxidative stress
inflammation
infection
priming
apoptosis
uremic toxins
polymorphonuclear leukocytes
monocytes
antigen-presenting cells
title Immune Dysfunction in Uremia—An Update
title_full Immune Dysfunction in Uremia—An Update
title_fullStr Immune Dysfunction in Uremia—An Update
title_full_unstemmed Immune Dysfunction in Uremia—An Update
title_short Immune Dysfunction in Uremia—An Update
title_sort immune dysfunction in uremia amp 8212 an update
topic cardiovascular disease
oxidative stress
inflammation
infection
priming
apoptosis
uremic toxins
polymorphonuclear leukocytes
monocytes
antigen-presenting cells
url http://www.mdpi.com/2072-6651/4/11/962
work_keys_str_mv AT geraldcohen immunedysfunctioninuremiaamp8212anupdate
AT walterhhorl immunedysfunctioninuremiaamp8212anupdate