Role of Oxidant and Physiological Antioxidants in Progression of Chronic Renal Insufficiency

Background: Oxidative stress plays a role in the pathogenesis of several diseases, including chronic renal insufficiency (CRI). There is considerable disequilibrium between oxidants and anti-oxidants in patients with CRI. Hence, the present study was undertaken to determine the role of oxidant and physiological antioxidants in progression of CRI. Material and Methods: The patients suffering from chronic renal failure (CRF) admitted in the medicine and Nephrology ward of Krishna Hospital Medical Research Center, Karad as well as out patients were included in the study. The diagnosis of renal disorder was done on the basis of clinical history, medical examination and laboratory investigations of urine and blood. The study was performed on 110 subjects; 66 were patients with CRI and 44 were normal healthy controls. Results: The mean values of serum creatinine, blood urea nitrogen and plasma lipid peroxide (LPO) were significantly elevated in CRI patients as compared to the controls and showed increasing trend from stage I to stage IV. The activities of erythrocyte superoxide dismutase (SOD), catalase (CAT) and glutathione peroxidase (GPx) enzymes were found to be decreased in various stage of progressive renal failure. Also, it was found that level of transferrin was increased while albumin and ceruloplasm in values were decreased gradually in patients with progressive renal dysfunction. The plasma level of chain breaking antioxidant like ascorbic acid showed significant decrease with progression of renal failure while the bilirubin and uric acid levels were elevated in-patients with progressive renal failure. Conclusion: Free radicals are important mediators in many pathological and toxicological processes. Reduction in antioxidant capacity and increased lipid peroxidation probably plays a major role in progression of chronic renal failure.