Oxidative stress in hemodialysis: Causative mechanisms, clinical implications, and possible therapeutic interventions

Semin Dial. 2019 Jan;32(1):58-71. doi: 10.1111/sdi.12745. Epub 2018 Oct 4.

Abstract

Oxidative stress (OS) is the result of prooxidant molecules overwhelming the antioxidant defense mechanisms. Hemodialysis (HD) constitutes a state of elevated inflammation and OS, due to loss of antioxidants during dialysis and activation of white blood cells triggering production of reactive oxygen species. Dialysis vintage, dialysis methods, and type and condition of vascular access, biocompatibility of dialyzer membrane and dialysate, iron administration, and anemia all can play a role in aggravating OS, which in turn has been associated with increased morbidity and mortality. Oral or intravenous administration of antioxidants may detoxify the oxidative molecules and at least in part repair OS-mediated tissue damage. Lifestyle interventions and optimization of a highly biocompatible HD procedure might ameliorate OS development in dialysis.

Keywords: antioxidants; biocompatibility; hemodialysis; oxidative stress.

Publication types

  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Antioxidants / therapeutic use*
  • Female
  • Humans
  • Kidney Failure, Chronic / diagnosis
  • Kidney Failure, Chronic / mortality
  • Kidney Failure, Chronic / therapy*
  • Male
  • Oxidative Stress / physiology*
  • Prognosis
  • Reactive Oxygen Species / blood*
  • Renal Dialysis / adverse effects*
  • Renal Dialysis / methods
  • Risk Assessment
  • Survival Rate
  • Treatment Outcome

Substances

  • Antioxidants
  • Reactive Oxygen Species