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Oxidative stress in hemodialysis: Causative mechanisms, clinical implications, and possible therapeutic interventions
Author(s) -
Liakopoulos Vassilios,
Roumeliotis Stefanos,
Zarogiannis Sotirios,
Eleftheriadis Theodoros,
Mertens Peter R.
Publication year - 2018
Publication title -
seminars in dialysis
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.899
H-Index - 78
eISSN - 1525-139X
pISSN - 0894-0959
DOI - 10.1111/sdi.12745
Subject(s) - medicine , oxidative stress , hemodialysis , dialysis , reactive oxygen species , inflammation , anemia , intensive care medicine , erythropoietin , antioxidant , biocompatible material , pharmacology , immunology , biochemistry , chemistry , biomedical engineering
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.