Gut Endothelial Leakage of Endotoxin May Be the Source of Vascular Inflammation and Injury in CKD. How Can This Be Targeted?

The risk of cardiovascular events increases as glomerular filtration rate declines increasing as much as 35 fold in patients with Stage 5 chronic kidney disease (CKD).1 Despite the vast increase in risk in this population, biomarkers associated with risk in the general population, such as cholesterol level contribute little risk,2 while the primary biomarkers associated with increased risk are those linked to inflammation.3,4 One open question is identifying the causal pathway between inflammatory biomarkers, which themselves may simply provide evidence of inflammation and vascular injury.