TY - JOUR
T1 - Vascular toxicity of urea, a new “old player� in the pathogenesis of chronic renal failure induced cardiovascular diseases
AU - Ferrara, Pietro
PY - 2017
Y1 - 2017
N2 - Chronic kidney disease in children is an irreversible process that may lead to end-stage renal disease. The mortality rate in children with end-stage renal disease who receive dialysis increased dramatically in the last decade, and it is significantly higher compared with the general pediatric population. Furthermore, dialysis and transplant patients, who have developed end-stage renal disease during childhood, live respectively far less as compared with age/race-matched populations. Different reports show that cardiovascular disease is the leading cause of death in children with end-stage renal disease and in adults with childhood-onset chronic kidney disease, and that children with chronic kidney disease are in the highest risk group for the development of cardiovascular disease. Urea, which is generated in the liver during catabolism of amino acids and other nitrogenous metabolites, is normally excreted into the urine by the kidneys as rapidly as it is produced. When renal function is impaired, increasing concentrations of blood urea will steadily accumulate. For a long time, urea has been considered to have negligible toxicity. However, the finding that plasma urea is the only significant predictor of aortic plaque area fraction in an animal model of chronic renal failure -accelerated atherosclerosis, suggests that the high levels of urea found in chronic dialysis patients might play an important role in accelerated atherosclerosis in this group of patients. The aim of this review was to provide novel insights into the role played by urea in the pathogenesis of accelerated cardiovascular disease in renal failure.
AB - Chronic kidney disease in children is an irreversible process that may lead to end-stage renal disease. The mortality rate in children with end-stage renal disease who receive dialysis increased dramatically in the last decade, and it is significantly higher compared with the general pediatric population. Furthermore, dialysis and transplant patients, who have developed end-stage renal disease during childhood, live respectively far less as compared with age/race-matched populations. Different reports show that cardiovascular disease is the leading cause of death in children with end-stage renal disease and in adults with childhood-onset chronic kidney disease, and that children with chronic kidney disease are in the highest risk group for the development of cardiovascular disease. Urea, which is generated in the liver during catabolism of amino acids and other nitrogenous metabolites, is normally excreted into the urine by the kidneys as rapidly as it is produced. When renal function is impaired, increasing concentrations of blood urea will steadily accumulate. For a long time, urea has been considered to have negligible toxicity. However, the finding that plasma urea is the only significant predictor of aortic plaque area fraction in an animal model of chronic renal failure -accelerated atherosclerosis, suggests that the high levels of urea found in chronic dialysis patients might play an important role in accelerated atherosclerosis in this group of patients. The aim of this review was to provide novel insights into the role played by urea in the pathogenesis of accelerated cardiovascular disease in renal failure.
KW - Atherogenesis
KW - Atherosclerosis
KW - Cardiovascular disease
KW - Chronic renal failure
KW - Pediatrics, Perinatology and Child Health
KW - Urea
KW - Vascular toxicity
KW - Atherogenesis
KW - Atherosclerosis
KW - Cardiovascular disease
KW - Chronic renal failure
KW - Pediatrics, Perinatology and Child Health
KW - Urea
KW - Vascular toxicity
UR - http://hdl.handle.net/10807/111568
UR - http://www.turkpediatriarsivi.com/sayilar/309/buyuk/187-1931.pdf
U2 - 10.5152/TurkPediatriArs.2017.6314
DO - 10.5152/TurkPediatriArs.2017.6314
M3 - Article
SN - 1306-0015
VL - 52
SP - 187
EP - 193
JO - Turk Pediatri Arsivi
JF - Turk Pediatri Arsivi
ER -