Oxidative stress, renal anemia, and its therapies: is there a link?
In chronic kidney disease, anemia and oxidative stress are common features and both are involved in increasing morbidity and mortality. However, their relationship is still a matter of debate. This article is a review of published data and our experience and is intended to debate the pro and contra arguments concerning renal anemia and its 2 main therapeutic approaches, that are, erythropoietin and intravenous iron supplementation, as additional causes of oxidative stress in end-stage renal disease patients. To date, it seems more likely that renal anemia itself is the main contributor, and intravenous iron further enhances oxidative stress associated with chronic kidney disease. Future randomized prospective trials, with "hard" clinical end-points, are needed to establish the real effect of biochemical pro-oxidative changes on patient's outcome.
Căpuşă
Cristina
C
Department of Nephrology, Dr. Carol Davila Teaching Hospital of Nephrology, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania. ccalexandr@yahoo.com
Mircescu
Gabriel
G
D000740:Anemia / Q000188:drug therapy* / Q000209:etiology*; D002908:Chronic Disease; D004921:Erythropoietin / Q000009:adverse effects / Q000627:therapeutic use; D006801:Humans; D007501:Iron / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use; D007674:Kidney Diseases / Q000150:complications*; D015227:Lipid Peroxidation; D008077:Lipoproteins, LDL; D016877:Oxidants; D018384:Oxidative Stress; D006435:Renal Dialysis
D008077:Lipoproteins, LDL; D016877:Oxidants; C099252:oxidized low density lipoprotein; D004921:Erythropoietin; D007501:Iron