Fifteen years of research on nephrin: what we still need to know

Mortality among hemodialysis patients remains unacceptably high in the USA, especially among newly diagnosed endstage renal disease patients. Chronic inflammation is a risk factor for cardiovascular disease among HD patients. It has been shown that complications of the arteriovenous (AV) access are not just limited to overt infectious complications but they may also pose a threat as a haven for occult infection and can aggravate the chronic inflammatory state. This inflammatory state is characterized by failure to thrive, erythropoietin-resistant anemia, hypoalbuminemia, elevated plasma C-reactive protein levels, which are well-known risk factors for increased morbidity and mortality on dialysis. In this issue, Wasse et al. presents a paper that demonstrates in a large cohort that failed AV grafts are associated with increased chronic inflammatory markers. They have provided a IN F O C U S © The Author 2012. Published by Oxford University Press on behalf of ERA-EDTA. All rights reserved. 770