Oxidative stress and chronic renal disease : clinical aspects

Patients with chronic kidney disease (CKD) experience accelerated atherosclerosis, leading to excessive cardiovascular death; oxidative stress may be a pathogenic mediator of this process. Oxidative stress is highly prevalent in CKD patients. Accordingly, increased oxidative stress and/or reduced antioxidant defenses have been associated with endothelial dysfunction and increased carotid intima-media thickness in CKD patients. Other studies have found a possible association between oxidative stress and a faster progression rate of kidney damage. Oxidative stress may also influence response to erythropoiesis-stimulating agents. Among possible therapeutic approaches, the use of vitamin E seems to be the most promising. Why antioxidant therapy is not as effective as it would be expected from the role of oxidative stress in pathogenic mechanisms remains an open question.