The Clinical Utility and Plausibility of Oxidative and Antioxidant Variables in Chronic and End-Stage Kidney Disease: A Review of the Literature.

Oxidative stress (OS) is caused by an imbalance between the production of reactive oxygen species (ROS) in cells and tissues and the ability of the biological system to detoxify these products. In chronic kidney disease (CKD), OS contributes to deterioration of kidney function and disease progression. In patients with end-stage kidney disease undergoing hemodialysis or peritoneal dialysis, OS is further increased and associated with adverse clinical outcomes, including deterioration and subsequent loss of residual renal function, atherosclerosis, hypertension, cardiovascular disease and death. However, currently, there is no consensus or guidelines for the diagnosis and treatment of OS in these patients. Herein, we aim to present the existing data regarding biomarkers of OS, pro-oxidants (oxidized albumin, advanced oxidation protein products, xanthine oxidase/dehydrogenase, nitrite/nitrate, malondialdehyde) and antioxidants (superoxide dismutase, catalase, vitamin E, total antioxidant capacity, N-acetylcysteine) that are most clinically relevant and have been more extensively studied in patients with chronic kidney disease, aiming to provide a clearer understanding of this complex area.