# Oxidant and Antioxidant Levels in Different Stages of Chronic Kidney Disease

**Authors:** Pallavi Sagar, Ravi Shekhar, Kumar Pranay, Prit P Singh, Praveen Kumar

PMC · DOI: 10.7759/cureus.102115 · 2026-01-22

## TL;DR

This study shows that as chronic kidney disease progresses, oxidative stress increases, with higher damage markers and lower antioxidant levels in advanced stages.

## Contribution

The study provides evidence of progressive oxidative imbalance across CKD stages, emphasizing the role of oxidative stress in disease progression.

## Key findings

- Serum MDA levels increased progressively with CKD severity, highest in Stage V patients.
- SOD activity significantly decreased in CKD patients compared to controls, lowest in Stage V.
- Serum creatinine levels rose consistently with advancing CKD stages.

## Abstract

Background

Chronic kidney disease (CKD) is a progressive renal disorder strongly associated with oxidative stress, which contributes to renal damage and systemic complications. Oxidative stress results from an imbalance between the production of reactive oxygen species (ROS) and antioxidant defence mechanisms. This study aimed to evaluate oxidant and antioxidant levels across different stages of CKD.

Methods

This cross-sectional comparative study was conducted on 180 subjects, including 90 CKD patients and 90 healthy controls. CKD patients were classified into Stage III, Stage IV, and Stage V. Serum malondialdehyde (MDA) and superoxide dismutase (SOD) were measured to assess oxidative stress using standard laboratory assays. Data were analysed using one-way ANOVA with Brown-Forsythe adjustment, and a p-value <0.05 was considered statistically significant.

Results

A progressive increase in serum MDA and a significant decrease in SOD levels were observed across CKD stages compared with controls. Stage V patients demonstrated the highest MDA concentrations and the lowest SOD activity, indicating severe oxidative imbalance. Differences between groups were statistically significant (p < 0.001). Additionally, serum creatinine levels showed a consistent rising trend with advancing CKD severity.

Conclusion

The study findings indicate a shift toward oxidant dominance as CKD progresses, characterised by enhanced lipid peroxidation and reduced antioxidant enzyme activity. These biochemical alterations highlight the importance of oxidative stress monitoring in CKD and suggest the potential benefit of antioxidant-targeted therapeutic strategies. Further longitudinal and interventional research is necessary to explore the clinical impact of oxidative stress reduction on CKD outcomes.

## Linked entities

- **Chemicals:** malondialdehyde (PubChem CID 10964)
- **Diseases:** chronic kidney disease (MONDO:0005300)

## Full-text entities

- **Genes:** SOD1 (superoxide dismutase 1) [NCBI Gene 6647] {aka ALS, ALS1, HEL-S-44, IPOA, SOD, STAHP}
- **Diseases:** autoimmune/chronic inflammatory disease (MESH:D019693), tissue injury (MESH:D017695), chronic systemic illness (MESH:D002908), Kidney Disease (MESH:D007674), cardiovascular complications (MESH:D002318), infection (MESH:D007239), end-stage renal impairment (MESH:D007676), febrile illness (MESH:D005334), acute kidney injury (MESH:D058186), hepatic or malignant disorders (MESH:D009369), endothelial dysfunction (MESH:D014652), CKD (MESH:D051436), chronic systemic inflammation (MESH:D007249), fibrosis (MESH:D005355), mitochondrial dysfunction (MESH:D028361)
- **Chemicals:** TBARS (MESH:D017392), creatinine (MESH:D003404), ROS (MESH:D017382), lipid (MESH:D008055), MDA (MESH:D008315), superoxide (MESH:D013481), pyrogallol (MESH:D011748)
- **Species:** Homo sapiens (human, species) [taxon 9606]

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Source: https://tomesphere.com/paper/PMC12924888