Aspects of immune dysfunction in end-stage renal disease

Sawako Kato, Michal Chmielewski, Hirokazu Honda, Roberto Pecoits-Filho, Seiichi Matsuo, Yukio Yuzawa, Anders Tranaeus, Peter Stenvinkel, Bengt Lindholm

Research output: Contribution to journalReview articlepeer-review

800 Citations (Scopus)


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.

Original languageEnglish
Pages (from-to)1526-1533
Number of pages8
JournalClinical Journal of the American Society of Nephrology
Issue number5
Publication statusPublished - 09-2008
Externally publishedYes

All Science Journal Classification (ASJC) codes

  • Epidemiology
  • Critical Care and Intensive Care Medicine
  • Nephrology
  • Transplantation


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