Influence of dialysis modalities on serum AGE levels in end-stage renal disease patients.
BACKGROUND
The accumulation of advanced glycation end-products (AGEs) in end-stage renal disease (ESRD) influenced by dialysis modalities is of current interest. Highly permeable membranes in haemodialysis or haemofiltration should be able to eliminate circulating AGEs as well as their AGE precursors more efficiently.


METHODS
In our study, 10 non-diabetic and 10 diabetic ESRD patients were on haemodialysis with low-flux membranes (LF) followed by a cross-over haemodialysis with high-flux or super-flux polysulfone membranes (HF, SF) for 6 months each. We measured the protein-bound pentosidine and free pentosidine serum levels by high-performance liquid chromatography (HPLC) as well as the serum AGE peptide, AGE-beta(2)-microglobulin and beta(2)-microglobulin concentrations, using ELISA assays.


RESULTS
All parameters investigated were significantly higher in dialysis patients than in healthy subjects. The reduction rates during a single dialysis session were found to be higher using the SF than those obtained with the HF (free pentosidine 82.4+/-7.3 vs 76.6+/- 8.7%; AGE peptides 79.7+/-7.7 vs 62.3+/-14.7%; AGE-beta(2)-microglobulin 64.0+/-16.5 vs 45.4+/-17.7%; beta(2)-microglobulin 70.5+/-5.6 vs 58.2+/-6.0%). The protein-bound pentosidine levels remained constant over the respective dialysis sessions. In the 6-month treatment period with the SF, decreased pre-dialysis serum levels of protein-bound pentosidine, free pentosidine and AGE peptides were observed in non-diabetics and diabetics as compared with values obtained with the LF. The respective pre-dialysis AGE-beta(2)-microglobulin concentrations decreased insignificantly, whereas those of beta(2)-microglobulin were significantly lower. Using the HF dialyser, only moderate changes of the parameters measured were noted.


CONCLUSIONS
Treatment with the biocompatible polysulfone SF dialyser seems to be better suited to lower serum AGE levels and to eliminate their precursors.
Stein
G
G
Department of Internal Medicine IV, Friedrich Schiller University of Jena, Erlanger Allee 101, D-07740 Jena, Germany.
Franke
S
S
Mahiout
A
A
Schneider
S
S
Sperschneider
H
H
Borst
S
S
Vienken
J
J
D000328:Adult; D000368:Aged; D001120:Arginine / Q000031:analogs & derivatives* / Q000097:blood; D001672:Biocompatible Materials; D018592:Cross-Over Studies; D005260:Female; D017127:Glycation End Products, Advanced / Q000097:blood*; D006801:Humans; D007676:Kidney Failure, Chronic / Q000097:blood* / Q000628:therapy*; D008239:Lysine / Q000031:analogs & derivatives* / Q000097:blood; D008297:Male; D008567:Membranes, Artificial; D008875:Middle Aged; D011108:Polymers; D006435:Renal Dialysis; D012709:Serum Albumin / Q000032:analysis; D013450:Sulfones; D001613:beta 2-Microglobulin / Q000097:blood
D001672:Biocompatible Materials; D017127:Glycation End Products, Advanced; D008567:Membranes, Artificial; D011108:Polymers; D012709:Serum Albumin; D013450:Sulfones; D001613:beta 2-Microglobulin; C017662:polysulfone P 1700; D001120:Arginine; C062187:pentosidine; D008239:Lysine