Himmelfarb Jonathan
Department of Medicine, Division of Nephrology and Renal Transplantation, Maine Medical Center, Portland, Me., USA.
Contrib Nephrol. 2008;161:132-137. doi: 10.1159/000130658.
Patients with advanced chronic kidney disease are at a greatly increased cardiovascular risk that cannot be explained entirely by traditional cardiovascular risk factors. An increase in oxidative stress is proposed as a non-traditional cardiovascular risk factor in this patient population. Many laboratories have now unequivocally demonstrated that uremia is an increased oxidative stress state. Uremic oxidative stress is characterized biologically by an increase in lipid peroxidation products and reactive aldehyde groups as well as by increased retention of oxidized thiols. The pathophysiology of increased oxidative stress in uremia is multifactorial, but the retention of oxidized solute by the loss of kidney function is probably a major contributor.
晚期慢性肾病患者的心血管风险大幅增加，而传统心血管风险因素并不能完全解释这一现象。氧化应激增加被认为是该患者群体中的一种非传统心血管风险因素。现在许多实验室已经明确证明，尿毒症是一种氧化应激增加的状态。尿毒症氧化应激的生物学特征是脂质过氧化产物和活性醛基增加，以及氧化型硫醇的潴留增加。尿毒症中氧化应激增加的病理生理学是多因素的，但肾功能丧失导致氧化溶质的潴留可能是一个主要因素。
