Oxidative Stress and Nucleic Acid Oxidation in Patients with Chronic Kidney Disease

Figure 1

Synthesis of reactive oxygen species (ROS) in patients with chronic kidney disease (CKD). Excessive reactive ROS including ONOO⁻, OH⁻, and OCl⁻ are generated from oxygen through several main enzymes (NADPH oxidase, superoxide dismutase (SOD), and myeloperoxidase (MPO)). Several factors can also increase ROS generation, including cytokines (IL-8, IL-1β, and TNF-α) released from activated monocytes, uremic toxin (indoxyl sulfate), and endotoxin (LPS) from the HC procedure. The resulting excessive ROS can lead to nitrosative (ONOO⁻), chlorinative (OCl⁻), and oxidative (OH⁻) modifications to lipids, proteins, and DNA.