Role of oxidative stress in chronic kidney disease

Abstract

Kidneys are important organs of the renal system. Besides being one of the principal excretory organs of the body, these perform many important biological functions. Any impairment or dysfunction of the kidney persisting for more than a 3-month duration is termed as chronic kidney disease (CKD). There are many causes of CKD, the most important ones being diabetes and hypertension. The grading of CKD is done depending on the changes in the glomerular filtration rate (GFR). Oxidative stress is a common accompaniment to CKD. Increased production of oxidants, including reactive oxygen species (ROS), in CKD may be due to associated inflammation, abnormality of iron metabolism, or disturbed highdensity lipoprotein (HDL) metabolism besides other causes. The most common cause of mortality in CKD or end-stage renal disease (ESRD) is cardiovascular disease, and oxidative stress plays the main culprit in that. Various consequences of increased oxidative stress include endothelial dysfunction, left ventricular hypertrophy, and cardiac fibrosis. Mounting of inappropriate defense system involving nuclear factor erythroid 2-related factor 2 (Nrf2) and other antioxidants also adds up to the condition. This chapter is an attempt to throw light on these aspects, as well as important enzymatic markers for this disease. The therapeutic role of various measures to counter this oxidative stress in CKD will also be discussed.