Antioxidant strategies and oxidative stress dynamics in chronic kidney disease: an integrative insight

Chronic kidney disease (CKD) is a critical global health issue, marked by a progressive decline in kidney function and significant associated morbidity and mortality. Central to the pathogenesis of CKD is oxidative stress, characterized by an imbalance between the production of reactive oxygen species (ROS) and the body’s antioxidant defenses. This review provides an integrative insight into the roles of oxidative stress and antioxidants in CKD progression. It synthesizes current research, highlighting the pathogenic mechanisms through which oxidative stress exacerbates kidney damage - principally through inducing apoptosis and inflammation - and discusses the therapeutic potential of natural antioxidants. Our comprehensive literature search covered key databases including PubMed/MedLine, Science Direct, and Google Scholar, focusing on studies that elucidate the interplay between oxidative stress and antioxidants in CKD pathophysiology. While emerging evidence from preclinical studies suggests that antioxidants can play a protective role by neutralizing ROS, clinical trials remain insufficient to justify widespread adoption of antioxidant therapy in CKD treatment protocols. The review underscores the urgent need for more rigorous clinical studies to establish the efficacy and safety of antioxidant interventions in CKD patients. Future research should prioritize identifying effective antioxidant therapies and elucidating their mechanisms of action within the CKD context.