Dysregulation of Superoxide Dismutase in Chronic Sidney Disease

摘要

Chronic kidney disease (CKD) is commonly reported to be associated with oxidative stress but there is still controversy on the mechanism. Numerous sources of radical oxygen species (ROS) have been identified in CKD patients, especially in hemodialysis (HD) patients. Macro-phage activation, which produces ROS, is due in these patients to: accumulation of uremic toxins; dialysis membrane bio-incompatibility; influx of endotoxins from the dialysate, and immunologic and metabolic disorders such as diabetes and dyslipidemia [1]. Phagocyte myeloper-oxidase-mediated events have also been associated with the production of oxidized low-density lipoprotein [2]; advanced oxidation protein products and advanced gly-cation end products, which are considered potent mediators of inflammation [3]. Moreover, treatment of anemia with high levels of iron may induce oxidative stress [4]. The massive generation of ROS is all the more damaging given that CKD patients have a weaker antioxidant system due to a diet low in antioxidant vitamins and oligo-elements [5] and due to loss of antioxidants during HD sessions [6].