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Immune Dysfunction in Uremia 2020

Department of Nephrology and Dialysis, Medical University of Vienna, Vienna A-1090, Austria
Received: 4 June 2020 / Revised: 26 June 2020 / Accepted: 1 July 2020 / Published: 5 July 2020
(This article belongs to the Special Issue Immune Dysfunction in Uremia)
Cardiovascular disease and infections are major causes for the high incidence of morbidity and mortality of patients with chronic kidney disease. Both complications are directly or indirectly associated with disturbed functions or altered apoptotic rates of polymorphonuclear leukocytes, monocytes, lymphocytes, and dendritic cells. Normal responses of immune cells can be reduced, leading to infectious diseases or pre-activated/primed, giving rise to inflammation and subsequently to cardiovascular disease. This review summarizes the impact of kidney dysfunction on the immune system. Renal failure results in disturbed renal metabolic activities with reduced renin, erythropoietin, and vitamin D production, which adversely affects the immune system. Decreased kidney function also leads to reduced glomerular filtration and the retention of uremic toxins. A large number of uremic toxins with detrimental effects on immune cells have been identified. Besides small water-soluble and protein-bound compounds originating from the intestinal microbiome, several molecules in the middle molecular range, e.g., immunoglobulin light chains, retinol-binding protein, the neuropeptides Met-enkephalin and neuropeptide Y, endothelin-1, and the adipokines leptin and resistin, adversely affect immune cells. Posttranslational modifications such as carbamoylation, advanced glycation products, and oxidative modifications contribute to uremic toxicity. Furthermore, high-density lipoprotein from uremic patients has an altered protein profile and thereby loses its anti-inflammatory properties. View Full-Text
Keywords: cardiovascular disease; infections; oxidative stress; inflammation; immune cells; autophagy; uremic toxins; renin-angiotensin- system; erythropoietin; vitamin D cardiovascular disease; infections; oxidative stress; inflammation; immune cells; autophagy; uremic toxins; renin-angiotensin- system; erythropoietin; vitamin D
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MDPI and ACS Style

Cohen, G. Immune Dysfunction in Uremia 2020. Toxins 2020, 12, 439. https://0-doi-org.brum.beds.ac.uk/10.3390/toxins12070439

AMA Style

Cohen G. Immune Dysfunction in Uremia 2020. Toxins. 2020; 12(7):439. https://0-doi-org.brum.beds.ac.uk/10.3390/toxins12070439

Chicago/Turabian Style

Cohen, Gerald. 2020. "Immune Dysfunction in Uremia 2020" Toxins 12, no. 7: 439. https://0-doi-org.brum.beds.ac.uk/10.3390/toxins12070439

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