Accumulation of advanced glycation end products and chronic complications in ESRD treated by dialysis.
Cardiovascular and connective tissue disorders are very common in patients with end-stage renal disease (ESRD), and the accumulation of advanced glycation end products (AGEs) is significantly increased in these patients. Accumulation of AGEs is believed to have a role in tissue protein aging and the pathogenesis of such age-related diseases as diabetes and ESRD. AGEs accumulate in patients with ESRD as a result of nonenzymatic glycation, oxidative stress, and diminished clearance of AGE precursors. Some AGEs show characteristic brown pigmentation and fluorescence, form protein-protein cross-links, and may ligate with AGE-specific receptors, inducing oxidative stress and cytokine production. This review focuses on the clinical relevance of AGE accumulation in patients with ESRD treated by dialysis for the development of long-term complications. The formation and accumulation of AGEs in patients with ESRD are discussed, as well as the relationship between AGE accumulation and such major complications of ESRD as cardiovascular and connective tissue disorders.
Meerwaldt
Robbert
R
Department of Surgery, Isala Clinics, Dr Heesweg 2, Zwolle, The Netherlands. r.meerwaldt@isala.nl
Zeebregts
Clark J
CJ
Navis
Gerjan
G
Hillebrands
Jan-Luuk
JL
Lefrandt
Joop D
JD
Smit
Andries J
AJ
D002318:Cardiovascular Diseases / Q000209:etiology / Q000378:metabolism; D003240:Connective Tissue Diseases / Q000209:etiology / Q000378:metabolism; D017127:Glycation End Products, Advanced / Q000378:metabolism*; D006801:Humans; D007676:Kidney Failure, Chronic / Q000150:complications / Q000378:metabolism / Q000628:therapy*; D018384:Oxidative Stress / Q000502:physiology; D006435:Renal Dialysis
D017127:Glycation End Products, Advanced