Plasma levels of advanced glycation end products during haemodialysis, haemodiafiltration and haemofiltration: potential importance of dialysate quality

Gerdemann, Andrea; Wagner, Zoltán; Solf, Andreas; Bahner, Udo; Heidland, A.; Vienken, Jörg; Schinzel, Reinhard

doi:10.1093/ndt/17.6.1045

Cited by 60 publications

(42 citation statements)

References 10 publications

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“…As for the intradialytic analysis, the results clearly show that AGE peptides and reference peptides were reduced by 40 and 70%, respectively, without differences between the four dialysis modalities. These findings are in line with those of other reports [9, 10,32,33,34] and implicate that a considerable part of both undefined uraemic peptides and AGE-modified peptides in end-stage renal disease consists of accumulated small-MW substances which are mainly cleared by diffusion. Although we cannot rule out with certainty the influence of the UF rate on the elimination of AGE peptides, convection does not seem to play a substantial role in this respect, as indicated by the fact that the four membranes used were characterized by a highly different cutoff point for the transfer of substances as indicated by the manufacturer (low-flux PS: 6–8 kDa, high-flux PS: 20–30 kDa, superflux PS and CTA: 40–50 kDa).…”

Section: Discussionsupporting

confidence: 93%

Influence of Different Haemodialysis Modalities on AGE Peptide Levels: Intradialytic versus Long-Term Results

et al. 2005

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Background: Peptide-linked degradation products of advanced glycation end products (AGE peptides) accumulate in chronic haemodialysis (HD) patients and may contribute to a number of HD-related long-term complications, such as accelerated atherosclerosis. Methods: The influence of a single HD session versus long-term HD on serum AGE peptides was determined. The patients were randomized to HD with a low-flux polysulfone (PS; F 6HPS), a high-flux PS (F 60S), a superflux PS (F 500S), or a superflux cellulose triacetate (CTA; Tricea 150G) dialyzer. Results: During a single HD session, both AGE peptides and reference peptides decreased significantly (AGE peptides: Tricea 150G –37.0 ± 2.9%; F 6HPS –35.5 ± 2.4%; F 60S –39.5 ± 4.7%, and F 500S –43.3 ± 2.1%, p = 0.005; reference peptides: Tricea 150G –73.2 ± 8.8%; F 6HPS –73.2 ± 7.9%; F 60S –72.5 ± 8.2%, and F 500S –74.1 ± 7.3%, p = 0.005). After 12 weeks of HD with the superflux CTA, the AGE peptide levels decreased significantly (week 1: 2.7 ± 1.1 arbitrary units, week 12: 2.5 ± 1.2 arbitrary units, decrease 7.4%; p = 0.01), whereas the AGE peptide levels remained unchanged after HD with each of the other three modalities. The reference peptide levels did not change after 12 weeks of HD. Conclusion: Although AGE peptides can be effectively removed during a single HD session, superflux CTA seems to be the only modality capable of reducing AGE peptides in the long term.

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Section: Discussionsupporting

confidence: 93%

Influence of Different Haemodialysis Modalities on AGE Peptide Levels: Intradialytic versus Long-Term Results

et al. 2005

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“…These antiradical stress effects are presumed to be exerted by effective removal of radical carrier protein, denatured protein, and complement protein in HDF and by dilution of radicals by massive use of replacement solution. Another earlier study from Germany indicated that convective dialysis modalities resulted in less oxidative stress represented by decreased AGE generation, but this beneficial effect was attributed to ultrapure dialysis fluid used in the study patients [39]. In general, a paucity of data on the influence of standard HDF on inflammatory and oxidative stress biomarkers was documented from a thorough search of the available literature.…”

Section: Discussionmentioning

confidence: 99%

“…Although studies on the impact of HDF on inflammatory and oxidative stress biomarkers are limited, the results of several studies published recently have suggested the superiority of online HDF to HD by remarkable removal of β 2 -microglobulin and other middle-sized molecules, as well as by significant reduction of pro-inflammatory mediators [39,40,41]. The enhanced convective clearance achieved by HDF is the primary mechanism for removing larger uremic solutes, such as inflammatory biomarkers [41].…”

Section: Discussionmentioning

confidence: 99%

Inflammation and Oxidative Stress in Patients on Hemodiafiltration

et al. 2008

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“…The use of ultrapure HD fluid appears to results in lower plasma levers in HD patients. Several studies showed that ultrapure dialysate decreases plasma levels of AGE in HD patients [45,46]. The reduction of plasma AGE by use of ultrapure dialysate is achieved regardless of dialyzer membrane type [47].…”

Section: Use Of Advanced Hemodialysis Techniquesmentioning

confidence: 99%

Advanced glycation end-products and skin autofluorescence in end-stage renal disease: a review

Arsov¹,

Graaff

Oeveren

et al. 2014

Clinical Chemistry and Laboratory Medicine

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Chronic kidney disease (CKD), especially in its end stage, is marked by extremely high cardiovascular rates of morbidity and mortality; hemodialysis patients have a five-fold shorter life expectancy than healthy subjects of the same age. In CKD the metabolic products that accumulate in the body are so-called uremic toxins. These include advanced glycation end-products (AGE). AGE levels are markedly increased in CKD patients not only because of impaired excretion but also because of increased production. AGE formation has initially been described as a non-enzymatic reaction between proteins and glucose in the so-called Maillard reaction, but they are also more rapidly formed during oxidative stress and subsequent formation of reactive carbonyl compounds like (methyl)glyoxal. AGE accumulate in tissue where they cross-link with proteins, e.g., collagen, inducing tissue stiffening of blood vessels and skin. They may also interact with receptor of AGE (RAGE) and other receptors, which lead to activation of intracellular transduction mechanisms resulting in cytokine release and further tissue damage in CKD. The accumulation of AGE in the skin can be measured non-invasively using autofluorescence. The skin autofluorescence is a strong marker of cardiovascular mortality in CKD. The focus of this review is on the role of tissue and plasma AGE, and of skin autofluorescence as a proxy of tissue AGE accumulation, in the increase in cardiovascular disease in end stage renal disease (ESRD). This review will also present the possibility of reducing the AGE accumulation in ESRD patients using the following five methods: 1) use of low AGE peritoneal dialysis solutions; 2) use of advanced hemodialysis techniques; 3) use of AGE reducing drugs; 4) optimizing the nutrition of hemodialysis patients; and 5) renal transplantation.

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Plasma levels of advanced glycation end products during haemodialysis, haemodiafiltration and haemofiltration: potential importance of dialysate quality

Cited by 60 publications

References 10 publications

Influence of Different Haemodialysis Modalities on AGE Peptide Levels: Intradialytic versus Long-Term Results

Influence of Different Haemodialysis Modalities on AGE Peptide Levels: Intradialytic versus Long-Term Results

Inflammation and Oxidative Stress in Patients on Hemodiafiltration

Advanced glycation end-products and skin autofluorescence in end-stage renal disease: a review

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