[Cytokines, metalloproteinases, neopterin and cardiovascular mortality among patients with chronic renal failure].

Among patients with chronic renal failure 10-20 times higher cardiovascular mortality than in the control group is observed. It increases further among dialyzed patients. The occurrence of the traditional risk factors only partially explains this phenomenon. Increasing evidence suggests that disturbances in the complex system of cytokine network, matrix metalloproteinases and oxidative stress may cause acceleration of the course of atherosclerosis. The activation of immunological response (partially as a result of infections) leads to exceeded expresion of proinflammatory cytokines, dysregulation of matrix metalloproteinases and their inhibitors system and increased synthesis of neopterine. These processes induce in turn oxidative stress and separately result in atherosclerosis progression. New possibilities of therapeutic interventions seem to appear, e.g. involving cytokine network. They may bring us closer to the aim, which is improvement of prognosis in chronic renal insufficiency.