title: Advanced glycation end products and their circulating receptors and level of kidney function in older community-dwelling women.
abstract: BACKGROUND
  Advanced glycation end products (AGEs) and the receptor for AGE (RAGE) are implicated in the pathogenesis of kidney disease; however, their relation with level of kidney function has not been well characterized.
  
  
  METHODS
  Cross-sectional and prospective.
  
  
  METHODS
  548 moderately to severely disabled community-dwelling women in the Women's Health and Aging Study I in Baltimore, MD.
  
  
  METHODS
  Serum carboxymethyl-lysine (CML), a dominant AGE; total soluble RAGE (sRAGE); and endogenous secretory RAGE (esRAGE).
  
  
  METHODS
  Glomerular filtration rate (GFR), prevalent and incident decreased GFR (GFR < 60 mL/min/1.73 m(2)). Serum CML, sRAGE, and esRAGE.
  
  
  RESULTS
  Of 548 women, 283 (51.6%) had decreased GFR at baseline. Serum CML level was associated with decreased GFR (OR [all expressed per 1 SD], 1.98; 95% CI, 1.41 to 2.76; P < 0.001) in a multivariate logistic regression model adjusting for age, race, hemoglobin A(1c) level, and chronic diseases. Serum sRAGE and esRAGE levels (both in nanograms per milliliter) were associated with decreased GFR (OR, 1.42; 95% CI, 1.12 to 1.79; P = 0.003; OR, 1.42; 95% CI, 1.14 to 1.77; P = 0.001, respectively) in separate multivariate logistic regression models adjusting for potential confounders. Of 230 women without decreased GFR at baseline, 32 (13.9%) developed decreased GFR by the follow-up visit 12 months later. Serum CML (in micrograms per milliliter), sRAGE, and esRAGE levels at baseline were associated with the prevalence of decreased GFR 12 months later (OR, 1.80; 95% CI, 1.19 to 2.71; P = 0.005; OR, 1.32; 95% CI, 1.01 to 1.74; P = 0.05; and OR, 1.33; 95% CI, 1.01 to 1.77; P = 0.05, respectively) in separate multivariate logistic regression models adjusting for potential confounders.
  
  
  CONCLUSIONS
  Small number of incident cases, limited follow-up, creatinine values not standardized.
  
  
  CONCLUSIONS
  AGE and circulating RAGE levels are independently associated with decreased GFR and seem to predict decreased GFR. AGEs are amenable to interventions because serum AGE levels can be decreased by change in dietary pattern and pharmacological treatment.
authors.affiliation: Johns Hopkins Medical Institutions, 550 N Broadway, Baltimore, MD 21205, USA. rdsemba@jhmi.edu
authors.forename: Richard D
authors.initials: RD
authors.lastname: Semba
authors.forename: Luigi
authors.initials: L
authors.lastname: Ferrucci
authors.forename: Jeffrey C
authors.initials: JC
authors.lastname: Fink
authors.forename: Kai
authors.initials: K
authors.lastname: Sun
authors.forename: Justine
authors.initials: J
authors.lastname: Beck
authors.forename: Mansi
authors.initials: M
authors.lastname: Dalal
authors.forename: Jack M
authors.initials: JM
authors.lastname: Guralnik
authors.forename: Linda P
authors.initials: LP
authors.lastname: Fried
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D015415:Biomarkers / Q000097:blood; D003430:Cross-Sectional Studies; D005260:Female; D005919:Glomerular Filtration Rate / Q000502:physiology; D017127:Glycation End Products, Advanced / Q000097:blood*; D006801:Humans; D007668:Kidney / Q000502:physiology*; D008239:Lysine / Q000031:analogs & derivatives / Q000097:blood; D015233:Models, Statistical; D015999:Multivariate Analysis; D011446:Prospective Studies; D000067759:Receptor for Advanced Glycation End Products; D011971:Receptors, Immunologic / Q000097:blood*; D012111:Residence Characteristics; D015398:Signal Transduction / Q000502:physiology
chemical_list: D015415:Biomarkers; D017127:Glycation End Products, Advanced; D000067759:Receptor for Advanced Glycation End Products; D011971:Receptors, Immunologic; C048496:N(6)-carboxymethyllysine; D008239:Lysine
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