Secondary Immunodeficiency Related to Kidney Disease (SIDKD)-Definition, Unmet Need, and Mechanisms.
Adaptive Immunity
Blood Platelets
/ immunology
COVID-19
/ etiology
COVID-19 Vaccines
/ immunology
Gastrointestinal Microbiome
/ immunology
Humans
Immunity, Innate
Immunologic Deficiency Syndromes
/ etiology
Immunophenotyping
Models, Immunological
Pandemics
Renal Insufficiency, Chronic
/ complications
Risk Factors
SARS-CoV-2
Seroconversion
chronic inflammation
immunodeficiency
infection
kidney disease
Journal
Journal of the American Society of Nephrology : JASN
ISSN: 1533-3450
Titre abrégé: J Am Soc Nephrol
Pays: United States
ID NLM: 9013836
Informations de publication
Date de publication:
02 2022
02 2022
Historique:
pubmed:
16
12
2021
medline:
5
2
2022
entrez:
15
12
2021
Statut:
ppublish
Résumé
Kidney disease is a known risk factor for poor outcomes of COVID-19 and many other serious infections. Conversely, infection is the second most common cause of death in patients with kidney disease. However, little is known about the underlying secondary immunodeficiency related to kidney disease (SIDKD). In contrast to cardiovascular disease related to kidney disease, which has triggered countless epidemiologic, clinical, and experimental research activities or interventional trials, investments in tracing, understanding, and therapeutically targeting SIDKD have been sparse. As a call for more awareness of SIDKD as an imminent unmet medical need that requires rigorous research activities at all levels, we review the epidemiology of SIDKD and the numerous aspects of the abnormal immunophenotype of patients with kidney disease. We propose a definition of SIDKD and discuss the pathogenic mechanisms of SIDKD known thus far, including more recent insights into the unexpected immunoregulatory roles of elevated levels of FGF23 and hyperuricemia and shifts in the secretome of the intestinal microbiota in kidney disease. As an ultimate goal, we should aim to develop therapeutics that can reduce mortality due to infections in patients with kidney disease by normalizing host defense to pathogens and immune responses to vaccines.
Identifiants
pubmed: 34907031
pii: 00001751-202202000-00004
doi: 10.1681/ASN.2021091257
pmc: PMC8819985
doi:
Substances chimiques
COVID-19 Vaccines
0
Types de publication
Journal Article
Research Support, Non-U.S. Gov't
Review
Langues
eng
Sous-ensembles de citation
IM
Pagination
259-278Informations de copyright
Copyright © 2022 by the American Society of Nephrology.
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