Cited by 195Advanced Glycation End Products researchDialysis and Renal Disease ManagementChronic Kidney Disease and Diabetes

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Advanced glycation end products and mortality in hemodialysis patients

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Schwedler, Susanne B., Metzger, Thomas, Schinzel, Reinhard, Wanner, Christoph·2002·Kidney International

DOI 10.1046/j.1523-1755.2002.00423.x

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Abstract

Background Advanced glycation and oxidation end products (AGEs) cause oxidative stress and trigger cytokine driven inflammatory reactions in vitro. The net effects on markers of inflammation and acute phase proteins in vivo as well as their influence on survival in hemodialysis patients are unknown.Methods We conducted a cross-sectional study in 312 stable hemodialysis patients and analyzed the interrelationships of AGEs and C-reactive protein (CRP) and their predictive effect on all-cause as well as cardiovascular mortality. Mortality was monitored prospectively over a period of 32 months. AGEs were determined by measuring total serum fluorescent AGEs (AGE-fl) and Nepsilon-(carboxymethyl)-lysine (CML).Results The levels of AGE-fl, CML and CRP were 3.2-, 3.8- and 10-fold higher as compared to healthy controls. AGE-fl and CML levels correlated significantly with each other but not with CRP or serum albumin. Patients with high (above median values) AGE-fl or CML levels (109 x 103 AU and 1.4 microg/mL, respectively) had a significant better survival than those with low (below median values) AGE-fl or CML levels. Patients with high CRP levels (above 7.7 mg/L = median value) had a better survival than those with low CRP (below median value) when AGE-fl or CML levels were high in parallel.Conclusions In contrast to in vitro data and to current hypotheses, the presence of high serum AGEs, as measured by AGE-fl and CML, were not linked to increased mortality. Statistically, high serum AGEs partly overcame the negative impact of the acute phase response on mortality in hemodialysis patients. Whether the benefit of high serum AGEs is an epiphenomenon or reflects a better nutritional support needs further studies.

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Authors: Schwedler, S. B., Metzger, T., Schinzel, R., & Wanner, C.
Affiliations: University of Würzburg (DE)
Corresponding author: Wanner, Christoph
ORCID: Schinzel, Reinhard
Wanner, Christoph
Venue: Kidney International
Publisher: Elsevier BV
Published: 2002-07
Volume: 62
Issue: 1
Pages: 301-310
ISSN: 0085-2538 (ISSN-L)
DOI: 10.1046/j.1523-1755.2002.00423.x
OpenAlex: W2013180282
Cited by: 195
References: 38
Citations by year: 2026: 1 · 2025: 1 · 2024: 3 · 2023: 1 · 2022: 1 · 2021: 3 · 2020: 1 · 2019: 4 · 2018: 6 · 2017: 2 · 2016: 6 · 2015: 12 · 2014: 9 · 2013: 10 · 2012: 12
FWCI: 10.10
Type: journal article
Language: en
Open access: bronze
doi.org
Licence: www.elsevier.com/tdm/userlicense/1.0/ (tdm)
www.elsevier.com/open-access/userlicense/1.0/ (vor, 4907 d)
Locations: Kidney International (publishedVersion)
PubMed (publishedVersion)
Topics: Life Sciences › Biochemistry, Genetics and Molecular Biology › Clinical Biochemistry › Advanced Glycation End Products research
Health Sciences › Medicine › Nephrology › Dialysis and Renal Disease Management
Health Sciences › Medicine › Nephrology › Chronic Kidney Disease and Diabetes
Keywords: advanced glycation end products, hemodialysis patients, mortality, C-reactive protein, carboxymethyllysine, acute phase response, inflammation, cardiovascular mortality, all-cause mortality, survival
MeSH terms: Adult, Aged, Aged, 80 and over, Aspirin, C-Reactive Protein, Female, Renal Dialysis, Humans, Lysine, Male, Middle Aged, Serum Albumin, Survival Rate, Glycation End Products, Advanced

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Advanced glycation end products and mortality in hemodialysis patients

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