Cardiovascular Disease and Inflammation

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.