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      Aspects of immune dysfunction in end-stage renal disease.

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          Abstract

          End-stage renal disease (ESRD) is associated with significantly increased morbidity and mortality resulting from cardiovascular disease (CVD) and infections, accounting for 50% and 20%, respectively, of the total mortality in ESRD patients. It is possible that these two complications are linked to alterations in the immune system in ESRD, as uremia is associated with a state of immune dysfunction characterized by immunodepression that contributes to the high prevalence of infections among these patients, as well as by immunoactivation resulting in inflammation that may contribute to CVD. This review describes disorders of the innate and adaptive immune systems in ESRD, underlining the specific role of ESRD-associated disturbances of Toll-like receptors. Finally, based on the emerging links between the alterations of immune system, CVD, and infections in ESRD patients, it emphasizes the potential role of the immune dysfunction in ESRD as an underlying cause for the high mortality in this patient population and the need for more studies in this area.

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          Author and article information

          Journal
          Clin J Am Soc Nephrol
          Clinical journal of the American Society of Nephrology : CJASN
          American Society of Nephrology (ASN)
          1555-905X
          1555-9041
          Sep 2008
          : 3
          : 5
          Affiliations
          [1 ] Division of Renal Medicine, Department of Clinical Science, Intervention and Technology, Karolinska Institutet, Stockholm, Sweden.
          Article
          CJN.00950208
          10.2215/CJN.00950208
          4571158
          18701615
          4f407809-b81a-40a2-b0e9-1b4e792af809
          History

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