title: Low glucose degradation product peritoneal dialysis regimen is associated with lower plasma EN-RAGE and HMGB-1 proinflammatory ligands of receptor for advanced glycation end products.
abstract: Intraperitoneal glucose degradation products (GDP) load influences systemic advanced glycation end products (AGEs) but the effects on soluble receptor for AGEs (s-RAGE) and its proinflammatory ligands: extracellular newly identified receptor for advanced glycation end-products binding protein(EN-RAGE) and high mobility group box-1 protein (HMGB-1) are unknown. We aimed to compare plasma and peritoneal s-RAGE, EN-RAGE and HMGB-1 between three peritoneal dialysis (PD) prescription regimens with different intraperitoneal GDP loads. High GDP load (glucose-lactate PD fluid, D; N = 8) was compared with a low (glucose-bicarbonate/lactate with icodextrin for overnight dwell, E; N = 9) and a very low GDP load (glucose-bicarbonate/lactate, P; N = 16). D group demonstrated higher plasma EN-RAGE, 77.8 ng/mL, vs. both E, 11.2, P < 0.001 and P, 27.0, P < 0.001 as well as higher plasma HMGB-1, 2.2 ng/mL vs. both E, 1.1, P < 0.01 and P, 1.5, P < 0.01. Plasma s-RAGE, which did not differ between D, E and P, correlated with its effluent levels. Patients with faster peritoneal transport (D/Pcr > 0.65) tended to have higher plasma s-RAGE compared to slow transporters (2300 vs. 1762 pg/mL, P = 0.056). Peritoneal clearance of s-RAGE and EN-RAGE was higher with E compared to both D and P (P < 0.001 resp. P < 0.01). Subgroup of PD patients with CRP above median demonstrated higher plasma HMGB-1 and EN-RAGE, P < 0.05 for both. A lower intraperitoneal GDP load is associated with decreased plasma levels of EN-RAGE and HMGB-1. Peritoneal transport, microinflammation and the capability of icodextrin to increase peritoneal clearance of middle molecular weight substances might also exert an effect on plasma s-RAGE and its proinflammatory ligands levels.
authors: Medicine I, Charles University Medical School, Pilsen, Czech Republic.
authors: Sylvie
authors: S
authors: Opatrna
authors: Anna
authors: A
authors: Popperlova
authors: Marta
authors: M
authors: Kalousová
authors: Tomas
authors: T
authors: Zima
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001692:Biological Transport / Q000502:physiology; D016022:Case-Control Studies; D005260:Female; D005936:Glucans / Q000008:administration & dosage; D005947:Glucose / Q000008:administration & dosage / Q000378:metabolism; D017127:Glycation End Products, Advanced / Q000378:metabolism*; D024243:HMGB1 Protein / Q000378:metabolism*; D006801:Humans; D000077607:Icodextrin; D018836:Inflammation Mediators / Q000378:metabolism; D008024:Ligands; D008297:Male; D008875:Middle Aged; D010530:Peritoneal Dialysis / Q000379:methods*; D010537:Peritoneum / Q000378:metabolism; D000067759:Receptor for Advanced Glycation End Products; D011971:Receptors, Immunologic / Q000378:metabolism*; D055815:Young Adult
chemical_list: D005936:Glucans; D017127:Glycation End Products, Advanced; D024243:HMGB1 Protein; D018836:Inflammation Mediators; D008024:Ligands; D000067759:Receptor for Advanced Glycation End Products; D011971:Receptors, Immunologic; D000077607:Icodextrin; D005947:Glucose
keywords: Advanced glycation end products; Extracellular newly identified receptor for advanced glycation end products-binding protein; High mobility group box-1 protein; Peritoneal dialysis; Receptor for advanced glycation end products