Oxidative stress in renal dysfunction: mechanisms, clinical sequelae and therapeutic options.
Oxidative stress has been increasingly linked to the high incidence of cardiovascular events in patients with chronic kidney disease (CKD), especially as traditional cardiovascular risk factors seem to not be able to account for the huge cardiovascular morbidity and mortality in this population group. Oxidative stress is increased in patients with renal impairment as a result of increased oxidant activity and reduced antioxidant capacity, and this is increased in a graded manner with increasing renal dysfunction. Inflammation, which is also present in CKD, further amplifies the oxidant generation process. The two clinical sequelae of oxidative stress are endothelial dysfunction and left ventricular hypertrophy, which have adverse cardiovascular consequences. With our new understanding of oxidative stress, it is now important to assess treatment options that reduce it in the hope that they reverse endothelial dysfunction and left ventricular hypertrophy and the clinical sequelae of these abnormalities.
Kao
M P C
MP
Division of Medical Sciences, Centre for Cardiovascular and Lung Biology, University of Dundee, Ninewells Hospital and Medical School, Dundee DD1 9SY, UK. m.kao@dundee.ac.uk
Ang
D S C
DS
Pall
A
A
Struthers
A D
AD
D004730:Endothelium, Vascular / Q000502:physiology; D006801:Humans; D017379:Hypertrophy, Left Ventricular / Q000209:etiology; D007674:Kidney Diseases / Q000188:drug therapy / Q000378:metabolism*; D007676:Kidney Failure, Chronic / Q000378:metabolism; D009569:Nitric Oxide / Q000502:physiology; D018384:Oxidative Stress
D009569:Nitric Oxide