Novel approaches targeted toward oxidative stress for the treatment of chronic kidney disease.
OBJECTIVE
Chronic kidney disease is a worldwide health problem that affects about 10% of the adult population. No major advances have been made in the treatment of this common disease, which leads to end-stage kidney disease and is associated with cardiovascular events and high economic costs. We review new approaches that are currently being explored to halt progression of kidney disease.


RESULTS
Redox balance plays a significant pathogenic role in the progression of kidney disease through regulation of signaling pathways, gene expression, cell proliferation, and fibrosis. In this review we define the term reactive oxygen metabolites, or oxidants, and discuss novel treatment modalities for diabetic and nondiabetic chronic kidney disease. Our emphasis here is on human studies and those agents that may have a direct or indirect link to oxidative stress and catalytic (labile) iron.


CONCLUSIONS
We believe that intercepting these pathways with one or more drugs may provide novel therapeutic modalities for halting progression of chronic kidney disease.
Swaminathan
Sundararaman
S
Division of Nephrology, Department of Internal Medicine, University of Arkansas for Medical Sciences, Little Rock, AR 72205, USA.
Shah
Sudhir V
SV
D015415:Biomarkers / Q000378:metabolism; D002908:Chronic Disease; D003928:Diabetic Nephropathies / Q000188:drug therapy* / Q000378:metabolism; D018450:Disease Progression; D015507:Drugs, Investigational / Q000494:pharmacology / Q000627:therapeutic use*; D017127:Glycation End Products, Advanced / Q000037:antagonists & inhibitors; D006801:Humans; D007211:Indoles / Q000627:therapeutic use; D007501:Iron / Q000378:metabolism; D007668:Kidney / Q000187:drug effects* / Q000201:enzymology / Q000378:metabolism; D007674:Kidney Diseases / Q000188:drug therapy* / Q000378:metabolism; D008301:Maleimides / Q000627:therapeutic use; D018384:Oxidative Stress / Q000187:drug effects*; D011493:Protein Kinase C / Q000037:antagonists & inhibitors; D047428:Protein Kinase Inhibitors / Q000627:therapeutic use; D011733:Pyridoxamine / Q000627:therapeutic use; D017382:Reactive Oxygen Species / Q000378:metabolism; D016896:Treatment Outcome; D014803:Vitamin B Complex / Q000627:therapeutic use
D015415:Biomarkers; D015507:Drugs, Investigational; D017127:Glycation End Products, Advanced; D007211:Indoles; D008301:Maleimides; D047428:Protein Kinase Inhibitors; D017382:Reactive Oxygen Species; D014803:Vitamin B Complex; D011733:Pyridoxamine; C099154:ruboxistaurin; D007501:Iron; D011493:Protein Kinase C