Inflammation as a target for improving health in chronic kidney disease.

Since the first reports in the late 1990s connecting elevated circulating levels of C-reactive protein in patients with end-stage renal disease with an atherogenic, wasted phenotype and poor outcome, more than 3600 publications related to the subject have appeared on the Medline bibliographic database. This reflects the exponential interest that this topic has evoked in the field of nephrology, and the possibility of treating this common uremic complication has been much discussed. Several small studies have implied that various nutritional and pharmacological treatment strategies have beneficial effects on surrogate markers of inflammation. However, no randomized controlled trials on anti-inflammatory treatment have yet been performed to test the hypothesis that persistent low-grade inflammation contributes to uremic morbidity and mortality.