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Cardiology Research and Practice
Volume 2011, Article ID 267257, 9 pages
http://dx.doi.org/10.4061/2011/267257
Review Article

Peripheral Vascular Dysfunction in Chronic Kidney Disease

Department of Kinesiology & Applied Physiology, University of Delaware, 541 South College Avenue, Newark, DE 19716, USA

Received 24 December 2010; Accepted 15 March 2011

Academic Editor: Abarmard Maziar Zafari

Copyright © 2011 Christopher R. Martens and David G. Edwards. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

There is an increased prevalence of cardiovascular disease- (CVD-) related mortality in patients with chronic kidney disease (CKD). Endothelial dysfunction is a primary event in the development of atherosclerosis and hypertension and likely contributes to the elevated cardiovascular risk in CKD. Endothelial dysfunction has been shown to occur in the peripheral vasculature of patients with both severe and moderate CKD. Mechanisms include oxidative stress, L-arginine deficiency, and elevated plasma levels of ADMA. Interventions designed to restore vascular function in patients with CKD have shown mixed results. Evidence from cell culture studies suggest that the accumulation of uremic toxins inhibits L-arginine transport and reduces nitric oxide production. The results of these studies suggest that endothelial dysfunction may become less reversible with advancing kidney disease. The purpose of this paper is to present the current literature pertaining to potential mechanisms of peripheral vascular dysfunction in chronic kidney disease and to identify possible targets for treatment.