Background: Chronic kidney disease [CKD] is characterized by reduced kidney function, accumulation of toxins, metabolic dysregulations, chronic oxidative stress and inflammation. This study evaluated the efficacy of some biomarkers related to oxidative stress and inflammation in CKD patients with and without anemia and assessed their diagnostic performance.

Methodes: A case-control study was involving 120 serum samples divided into: 50 apparently healthy subjects as control, 35 CKD patients without anemia, and 35 CKD patients with anemia. Serum myeloperoxidase ^[MPO^], ischemia‑modified albumin [IMA], total antioxidant capacity ^[TAC^], malondialdehyde [MDA], glutathione [GSH], nitric oxide ^[NO^], thiol parameters, iron indices, vitamin D3, parathyroid hormone ^[PTH^], and liver enzymes were quantified. ROC analysis evaluated the diagnostic utility of the biomarkers.

Results: Patients with CKD exhibited significantly ^[p≤0.05^] lower activity of MPO, ALT, AST, lower levels of IMA, TAC, NO, iron, and vitamin D3 and significantly ^[p≤0.05^] higher MDA, GSH, AST/ALT ratio, UIBC, and TIBC compared with controls. The levels of TAC, MDA, and GSH differed significantly [p≤0.05] between anemic and non‑anemic CKD groups. Myeloperoxidase demonstrated good diagnostic accuracy in differentiating CKD from controls [AUC ≈ 0.996]. The only marker capable of distinguishing CKD patients with anemia from those without anemia was TAC.