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 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 also influences the response to erythropoiesis-stimulating agents. Among possible therapeutic approaches, the use of vitamin E seems 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.