Abstract

Acute renal failure (ARF) is a condition characterized by a rapid decrease in renal function, leading to an imbalance in water and solutes metabolism. It constitutes a major cause of morbidity and mortality in hospitalized patients worldwide, mainly in elderly population. Despite the medical advances, over the past fifty years the mortality of ARF has not diminished. This is often attributed to increased risk factors prevalence, mainly those derived from changes in our lifestyle. However, it is also possible that the therapeutic methods used until these days are not aiming on the right direction, probably due to lack of knowledge about some of the mechanisms leading to the development and progression of ARF. Over the last decades a large body of evidence has emerged supporting a role of oxidative stress in the pathogenesis of a variety of diseases, including ARF. Indeed, both reactive oxygen and nitrogen species are thought to enhance tubular damage caused from either renal ischemia or direct toxic injury. Nevertheless, the role of oxidative stress in ARF pathogenesis has not been fully established and some evidence is even contradictory. A better understanding regarding the real contribution of oxidative stress to ARF development and progression is required for the design of potentially preventive interventions, such as antioxidant supplementation. Indeed, clinical trials on this matter have been carried out with promising results. This chapter presents an update of the current evidence supporting a role of oxidative stress in ARF pathophysiology, and the potential role of antioxidants in the prevention and treatment of this disease.