If Oxidative Stress Is an Appropriate and Specific Target, What Reagent Should We Choose?

Cardiovascular disease is prevalent in a disproportionately high percentage of patients on maintenance hemodialysis (MHD) and is responsible for much of the mortality in this population.1 In addition, MHD patients express markers of oxidative stress and inflammation at significantly higher levels than those in the general population. Increased oxidation of LDLs is associated with adverse cardiovascular outcomes, and evidence of protein and lipid oxidation (oxidative stress) seems to be closely linked with markers of inflammation. Within the MHD patient cohort, higher markers of inflammation and oxidative stress are associated with greater adverse outcomes. For these reasons, oxidative stress is theorized to play a large role in the morbidity and mortality of this population.2 It is logical, then, to consider the use of antioxidants in mitigating oxidative stress in these patients in order to improve cardiovascular outcomes.