Antioxidants' Function in The Treatment of Chronic Kidney Disease

Abstract

Chronic kidney disease (CKD) is a progressive disorder, which is associated with progressive loss of renal functionality, having oxidative stress as one of the key mechanisms that contribute to inflammation, fibrosis, and tissue damage. Studies on animals have been becoming increasingly interested in the therapeutic value of antioxidants in alleviating these pathogenic events. This review summarizes the evidence available on natural antioxidants, such as vitamins, polyphenols and flavonoids, and synthetic antioxidants, such as N-acetylcysteine and enzymatic mimetics, such as Tempol, in preclinical models of CKD. The evidence suggests that these agents are useful in reducing reactive oxygen species, increasing endogenous antioxidant defenses, preserving mitochondrial functions, and regulating pro-inflammatory, pro-fibrotic signaling pathways, which reduce renal injury and improve its functions. Comparative analysis has revealed that natural antioxidants present multi-targeted protection with limitations on bioavailability, synthetic antioxidants give strong intracellular protection mainly in renal tissues and enzyme mimetics have both renal and systemic cardiovascular effects. Even with these positive results, animal models, dosages, and long-term research are variable, thus making translation a problem. This review highlights the possibility of antioxidant therapy as an adjunctive intervention in the management of CKD and the need to have standard preclinical studies to maximize its efficacy and ease its future use in the clinical scene.