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

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  • Vassilios Liakopoulos
    Division of Nephrology and Hypertension, 1st Department of Internal Medicine AHEPA Hospital, School of Medicine, Aristotle University of Thessaloniki Thessaloniki Greece
  • Stefanos Roumeliotis
    Division of Nephrology and Hypertension, 1st Department of Internal Medicine AHEPA Hospital, School of Medicine, Aristotle University of Thessaloniki Thessaloniki Greece
  • Sotirios Zarogiannis
    Department of Physiology, Faculty of Medicine University of Thessaly Larissa Greece
  • Theodoros Eleftheriadis
    Division of Nephrology and Hypertension, 1st Department of Internal Medicine AHEPA Hospital, School of Medicine, Aristotle University of Thessaloniki Thessaloniki Greece
  • Peter R. Mertens
    Clinic of Nephrology and Hypertension, Diabetes and Endocrinology Otto‐von‐Guericke University Magdeburg Germany

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<jats:title>Abstract</jats:title><jats:p>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.</jats:p>

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