Oxidative stress and anemia

The increased production of reactive oxygen species under hypoxic condition s seems to be a paradox. The dysbalance of the prooxidative and antioxidati ve capacities towards the oxidation is the result of changes in the cellula r metabolism, e.g. the energy production of the cell, higher flux rates in the metabolic pathways of catecholamines and the permanent activation of ra dical-producing leukocytes. On the other side, the antioxidative capacity d eclined due to the lack of red blood cells. Erythrocytes are in the whole b lood one of the major components of the antioxidative capacity. The enzymat ic antioxidant defenses of the erythrocytes, like the superoxide dismutase, the catalase and the glutathione system have high activities in these cell s. Therefore, it is possible that some of the complications of uremia are a t least partially due to the action of reactive oxygen species. Cardiovascu lar complications, enhanced biological aging and increased susceptibility t o infections are some of the complications that may be free radical-enforce d. Therapeutic strategies directed towards the increase of the complex endo genous antioxidative defenses of the organisms may therefore be result in i mproved long-term outcomes of uremic patients. Therefore, the EPO therapy d irected towards the normalization of the blood erythrocyte content is a ste p to the improvement of the oxidative stress in uremic patients.