動脈硬化と尿毒症(<特集>動脈硬化とアフェレシス)

概要

論文の詳細を見る
Chronic kidney disease (CKD) is recognized as an independent risk factor for cardiovascular diseases (CVD). The progressive decrease in glomerular filtration rate (GFR) in CKD patients results in the accumulation of various uremic retention solutes which are excreted into the urine under normal renal function. Among them, compounds which have toxic effects on various cells and tissues are called uremic toxins. In recent years, a substantial body of evidence has been accumulating which shows an involvement of uremic toxins in the pathophysiology of vascular dysfunctions in CKD patients, including endothelial dysfunction, atherosclerosis, arteriosclerosis and vascular calcification. So far, higher blood levels of some uremic toxins, such as indoxyl sulfate, asymmetric dimethylarginine (ADMA), homocysteine, p-cresol and p-cresyl sulfate have been reported to be associated with cardiovascular morbidity and mortality in patients with CKD. In addition, there are increasing numbers of reports showing the precise molecular mechanisms of toxicity of uremic toxins to vascular system in vitro and in vivo. This article reviews recent findings and current views concerning the toxic effects of uremic toxins on the vascular system and therapeutic approaches for removing uremic toxins or their toxicity.
2013-02-28