Peripheral Vascular Dysfunction in Chronic Kidney Disease

Figure 1

Simplified schematic depicting mechanisms by which reactive oxygen species can reduce nitric oxide (NO) availability. NO is synthesized from eNOS and can combine with excess superoxide (O²⁻) from vascular oxidases to form peroxynitrite (ONOO⁻) limiting NO availability. Superoxide can also oxidize the eNOS cofactor tetrahydrobiopterin (BH₄), uncoupling eNOS and reducing NO synthesis.