The incidence and diagnosis of chronic kidney disease (CKD) is on the rise all over the
world. CKD is related to ageing of the society and high morb idity due to lif estyle diseases like diabetes,
atherosclerosis, and hypertension. CKD is associated with increased oxidative stress generated
by uremic toxicity, chronic inflammatory state, lack of vitamins and microelements, parenteral iron
administration, and dialysis procedure itself. In terms of cellular physiology, erythrocytes and blood
platelets in particular have effective enzymatic and non-enzymatic antioxidative system. The most efficient
enzymatic antioxidants include superoxide dismutase, catalase, glutathione peroxidase, glutathione
reductase, and glucose-6-phosphate dehydrogenase. Glutathione is the leading non-enzymatic free radical scavenger.
In CKD, antioxidative defense is impaired and the abnormal activity of the enzymes and glutathione concentration
is described in literature. The imbalance between the formation of reactive oxygen species and antioxidative system efficiency
takes part in the pathogenesis of cardiovascular complications. It contributes to increased morbidity and mortality
in patients with CKD. The severity of these processes depends on the type of renal replacement therapy; haemodialysis
(HD) is more predisposing to such disorders than peritoneal dialysis (PD), or even conservative treatment. This can influence
the outcome and the possibility of kidney transplantation. Moreover, the early function of kidney allograft seems to
be dependent on perioperative antioxidative ability of platelets, which can play a potential protective role in kidney transplantation.
Keywords: Antioxidative enzymes, chronic kidney disease, free radicals, haemodialysis, kidney transplantation, oxidative
stress, peritoneal dialysis, uraemia.
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