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Cardiovascular Disease and Inflammation

  • Living reference work entry
  • First Online:
Nolph and Gokal's Textbook of Peritoneal Dialysis

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Abstract

Cardiovascular disease (CVD) is the single leading cause of a markedly reduced lifespan among dialysis patients. The mechanism of the development of CVD in peritoneal dialysis (PD) patients is not fully understood. The CVD pattern is atypical in this population of patients, and only partially explained by traditional risk factors like demography, diabetes, hypertension, dyslipidemia, insulin resistance, and smoking. A large number of additional factors, some of them specific for PD, but many recognized as important in all individuals with chronic kidney disease (CKD), contribute to a high burden of CVD and adversely influence its prognosis. Those factors include, but are not limited to, oxidative stress, endothelial and autonomic dysfunctions, vascular calcification, advanced glycation end products, hyperhomocysteinemia, and genetic alterations.

In this chapter, we discuss the modifying role of CKD and dialysis on the prevalence and pathogenic role of traditional and novel risk factors of CVD, as well as its epidemiology, clinical consequences, and current therapeutic strategies. Special attention has been paid to inflammation, which stands out as a contributor to CVD and premature mortality in CKD, but which also is a target for entirely new therapeutic possibilities.

This contribution was authored by P. Stenvinkel and E. Ritz in the previous edition.

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Abbreviations

ACE-I:

Angiotensin-converting enzyme inhibitor

ADMA:

Asymmetric dimethylarginine

AGEs:

Advanced glycation end products

AMI:

Acute myocardial infarction

ARBs:

Angiotensin receptor blockers

BMI:

Body mass index

BNP:

Brain natriuretic peptide

BP:

Blood pressure

CABG:

Coronary artery bypass graft

CAD:

Coronary artery disease

CEC:

Circulating endothelial cells

CPAP:

Continuous positive airway pressure

CRP:

C-reactive protein

CVD:

Cardiovascular disease

CHF:

Congestive heart failure

GDPs:

Glucose degradation products

CKD:

Chronic kidney disease

CML:

Carboxymethyllysine

DM:

Diabetes mellitus

EBCT:

Electron beam computed tomography

EPC:

Endothelial progenitor cells

ESRD:

End-stage renal disease

GDPs:

Glucose degradation products

GLP-1RAs:

Glucagon-like peptide 1 receptor agonists

Hcys:

Homocysteine

HD:

Hemodialysis

HDL:

High-density lipoprotein

HT:

Hypertension

IL:

Interleukin

Lp(a):

Lipoprotein(a)

LV:

Left ventricular

LVH:

Left ventricular hypertrophy

MTHFR:

Methylenetetrahydrofolate reductase

NMMA:

N(G)-monomethyl-l-arginine

NO:

Nitric oxide

PD:

Peritoneal dialysis

PEW:

Protein-energy wasting

PVD:

Peripheral vascular disease

RAS:

Renin-angiotensin system

RRT:

Renal replacement therapy

SGLT2:

Sodium-glucose co-transporter type 2 inhibitors

TNF:

Tumor necrosis factor

TnT:

Troponin T

USRDS:

United States Renal Data System

VEGF:

Vascular endothelial growth factor

WHO:

World Health Organization

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Acknowledgments

The authors would like to acknowledge the substantial contributions of Professor Eberhard Ritz, University of Heidelberg, Heidelberg, Germany, who wrote parts of a previous version of this chapter that are included also in this updated chapter.

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Authors and Affiliations

  1. Department of Nephrology, Transplantology and Internal Medicine, Medical University of Gdańsk, Gdańsk, Poland

    Magdalena Jankowska

  2. Division of Renal Medicine and Baxter Novum, Karolinska Institutet, Stockholm, Sweden

    Bengt Lindholm

  3. Division of Renal Medicine, Karolinska Institutet, Stockholm, Sweden

    Peter Stenvinkel

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  1. Magdalena Jankowska
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  2. Bengt Lindholm
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  3. Peter Stenvinkel
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Correspondence to Peter Stenvinkel .

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Editors and Affiliations

  1. Nephrology, School of Medicine Department of Medicine Division of, Columbia, MO, USA

    Ramesh Khanna

  2. Dept. Medicine Div. Nephrology, University of Amsterdam Academic Medical Center, Amsterdam, The Netherlands

    Raymond T. Krediet

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Jankowska, M., Lindholm, B., Stenvinkel, P. (2021). Cardiovascular Disease and Inflammation. In: Khanna, R., Krediet, R.T. (eds) Nolph and Gokal's Textbook of Peritoneal Dialysis. Springer, Cham. https://doi.org/10.1007/978-3-319-90760-4_23-1

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