Darren Yuen1, Christopher T Chan. 1. Division of Nephrology, Toronto General Hospital - University Health Network, Ontario, Canada.
Abstract
PURPOSE OF REVIEW: There is a growing recognition that uremia is a proinflammatory condition. Chronic uremia-associated inflammation contributes to the pathogenesis of atherosclerosis, anemia and cardiovascular calcification in patients with end-stage renal disease (ESRD). Daily nocturnal hemodialysis (DNHD) is a form of frequent intensive renal replacement therapy that has multiple cardiovascular benefits. Here we will review the emerging data of DNHD on inflammation, coronary calcification and anemia management. RECENT FINDINGS: Increasing the dose and frequency of dialysis by DNHD has been demonstrated, in both short and long-term studies, to reverse several important risk factors for adverse cardiovascular events in ESRD patients. In addition, there are preliminary data indicating the positive effects of DNHD on inflammatory cytokine profile, rate of coronary calcification progression and enhanced erythropoietin responsiveness. SUMMARY: Augmentation of dialysis dose by DNHD may positively influence uremia-related inflammation. The role of intensive dialysis as a treatment for chronic inflammation requires further research.
PURPOSE OF REVIEW: There is a growing recognition that uremia is a proinflammatory condition. Chronic uremia-associated inflammation contributes to the pathogenesis of atherosclerosis, anemia and cardiovascular calcification in patients with end-stage renal disease (ESRD). Daily nocturnal hemodialysis (DNHD) is a form of frequent intensive renal replacement therapy that has multiple cardiovascular benefits. Here we will review the emerging data of DNHD on inflammation, coronary calcification and anemia management. RECENT FINDINGS: Increasing the dose and frequency of dialysis by DNHD has been demonstrated, in both short and long-term studies, to reverse several important risk factors for adverse cardiovascular events in ESRDpatients. In addition, there are preliminary data indicating the positive effects of DNHD on inflammatory cytokine profile, rate of coronary calcification progression and enhanced erythropoietin responsiveness. SUMMARY: Augmentation of dialysis dose by DNHD may positively influence uremia-related inflammation. The role of intensive dialysis as a treatment for chronic inflammation requires further research.