The involvement of oxidative stress in the progression of renal injury

That reactive oxygen species are involved in progressive renal injury is su pported by several lines of evidence: increased generation of oxidants occu rs in chronic renal injury; various antioxidant strategies exert beneficial effects in models of chronic renal injury; and, oxidative stress can induc e changes in the otherwise unmanipulated kidney that resemble those seen in chronic renal disease. Oxidants may contribute to progressive renal diseas e by virtue of their renal haemodynamic actions, by impairing glomerular pe rmselective properties, by inducing inordinate or aberrant growth responses , by inducing loss of cellular phenotype and apoptosis, and finally, by pro moting acute and chronic inflammatory responses. Certain adhesion molecules and proinflammatory mediators, and the transcription factor NF kappa B, ca n be upregulated by oxidants. Oxidants can also induce the fibrogenic cytok ine, TGF beta 1, one that is widely incriminated in progressive renal injur y. Reduction in renal oxidative stress by dietary or pharmacologic approach es provides an appealing target for therapies directed towards the retardat ion of progressive renal injury.