Carbamylation of proteins and atherogenesis in renal failure

The incidence of atherosclerosis is greatly increased in patients with chronic renal failure, and this increased risk is only partly explained by conventional risk factors. Carbamylation of proteins occurs in renal failure as a result of reactions between urea-derived cyanate and protein amino groups. A mechanism is proposed whereby oxidation of LDL cholesterol within the arterial wall may be enhanced as a result of carbamylation. This may be accentuated as a result of inhibition of antioxidant enzymes by carbamylation. The combination of these processes may lead to increased atherogenesis.