What is the role of antioxidants in the treatment of chronic glomerulonephritis?

Updated: Feb 24, 2020
  • Author: Moro O Salifu, MD, MPH, FACP; Chief Editor: Vecihi Batuman, MD, FASN  more...
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Answer

Cells have the ability to produce antioxidants, anti-inflammatory and detoxifying enzymes that are useful for cell viability, but this pathway is constantly being inhibited by an enzyme called KEAP. Inhibition of KEAP may therefore improve the antioxidant activity of cells and promote cell viability. Bardoxolone, an oleanolic acid derivative, blocks Keap and has been postulated as a potential mechanism to retard progression of CKD. In one study, patients receiving bardoxolone had significant increases in the mean (± standard deviation) estimated GFR, as compared with placebo, at 24 weeks. The improvement persisted at 52 weeks, suggesting that bardoxolone may have promise for the treatment of CKD, however a phase 3 randomized clinical trial failed to achieve the primary end point and was associated with side effects and so the study was stopped. [20] It is not likely that Bardoxolone will be used for renoprotection any time soon.


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