Serum carboxymethyl-lysine, a dominant advanced glycation end product, is associated with chronic kidney disease: the Baltimore longitudinal study of aging.
OBJECTIVE
Advanced glycation end products (AGEs) are modifiable risk factors for renal disease that were primarily studied in persons with diabetes or endstage renal disease. Our objective was to characterize the relationship between AGEs and renal function in community-dwelling adults.


METHODS
The presence of serum L-carboxymethyl-lysine (CML), a dominant AGE, was compared with renal function in a cross-sectional analysis.


METHODS
This study was part of the Baltimore Longitudinal Study of Aging in Baltimore, Maryland.


METHODS
Participants included community-dwelling men and women, aged 26 to 93 years, seen during a regular follow-up visit to the Baltimore Longitudinal Study of Aging between 2002 and 2007.


METHODS
The main outcome measures included chronic kidney disease (CKD) at stage >/=3 of the National Kidney Foundation classification (estimated glomerular filtration rate [eGFR] of<60 mL/minute/1.73 m(2)) and eGFR.


RESULTS
Of 750 adults, 121 (16.1%) had CKD. Serum CML was associated with CKD (odds ratio expressed per one standard deviation, 1.37; 95% confidence interval, 1.11 to 1.67; P=.003) in a multivariate logistic regression model adjusting for age, race, smoking, and chronic diseases. Serum CML was associated with eGFR (mL/minute/1.73 m(2)) (beta=-2.21, standard error=0.57, P=.0001) in a multivariate linear regression model, adjusting for age, race, smoking, and chronic diseases. After excluding patients with diabetes, serum CML was associated with CKD (odds ratio per one standard deviation, 1.38; 95% confidence interval, 1.12 to 1.70; P=.003) and eGFR (beta=-2.09, standard error=0.59, P=.0005), adjusting for the same covariates.


CONCLUSIONS
Serum CML, a dominant AGE, is independently associated with CKD and eGFR.
Department of Ophthalmology, Johns Hopkins University School of Medicine, Baltimore, Maryland 21205, USA. rdsemba@jhmi.edu
Richard D
RD
Semba
Jeffrey C
JC
Fink
Kai
K
Sun
B Gwen
BG
Windham
Luigi
L
Ferrucci
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000375:Aging; D015142:Baltimore; D002908:Chronic Disease; D003430:Cross-Sectional Studies; D005260:Female; D005919:Glomerular Filtration Rate; D017127:Glycation End Products, Advanced / Q000097:blood*; D006801:Humans; D007674:Kidney Diseases / Q000097:blood* / Q000145:classification; D016014:Linear Models; D008137:Longitudinal Studies; D008239:Lysine / Q000031:analogs & derivatives* / Q000097:blood; D008297:Male; D008875:Middle Aged; D044469:Racial Groups; D012907:Smoking
D017127:Glycation End Products, Advanced; C048496:N(6)-carboxymethyllysine; D008239:Lysine