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Oxidative Medicine and Cellular Longevity
Volume 2016 (2016), Article ID 8598253, 19 pages
Review Article

Systemic Redox Imbalance in Chronic Kidney Disease: A Systematic Review

1Department of Physical Education & Sport Science, University of Thessaly, Karyes, 421 00 Trikala, Greece
2Department of Kinesiology, Institute for Research and Technology-CERTH, Thessaly, Karyes, 421 00 Trikala, Greece
3School of Sports, Performing Arts & Leisure, University of Wolverhampton, Wolverhampton WV1 1LY, UK
4Department of Physical Education & Sport Science, National and Kapodistrian University of Athens, 172 37 Athens, Greece
5Department of Nephrology, School of Medicine, University of Thessaly, 411 10 Larissa, Greece
6Faculty of Sport and Health Sciences, University of St Mark and St John, Plymouth PL6 8BH, UK

Received 22 March 2016; Revised 31 May 2016; Accepted 7 June 2016

Academic Editor: Joachim Jankowski

Copyright © 2016 Konstantina P. Poulianiti et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


Patients with chronic kidney disease (CKD) experience imbalance between oxygen reactive species (ROS) production and antioxidant defenses leading to cell and tissue damage. However, it remains unclear at which stage of renal insufficiency the redox imbalance becomes more profound. The aim of this systematic review was to provide an update on recent advances in our understanding of how the redox status changes in the progression of renal disease from predialysis stages 1 to 4 to end stage 5 and whether the various treatments and dialysis modalities influence the redox balance. A systematic review was conducted searching PubMed and Scopus by using the Cochrane and PRISMA guidelines. In total, thirty-nine studies met the inclusion criteria and were reviewed. Even from an early stage, imbalance in redox status is evident and as the kidney function worsens it becomes more profound. Hemodialysis therapy per se seems to negatively influence the redox status by the elevation of lipid peroxidation markers, protein carbonylation, and impairing erythrocyte antioxidant defense. However, other dialysis modalities do not so far appear to confer advantages. Supplementation with antioxidants might assist and should be considered as an early intervention to halt premature atherogenesis development at an early stage of CKD.