THE ADVANCED GLYCATION ENDPRODUCT PENTOSIDINE AND MONOCYTE ACTIVATIONIN UREMIA

Rationale: Advanced glycation endproducts (AGEs) contribute to the pat hogenesis of vascular complications in diabetes, aging and end-stage r enal disease (ESRD). Immune abnormalities in patients with chronic ren al failure and those treated by dialysis contribute to high rates of m orbidity and mortality. We therefore sought a relationship between a c irculating marker of immune dysfunction and plasma levels of the AGE p entosidine. Method: We studied non-diabetic patients with mild to adva nced renal failure (n = 60), and with ESRD treated by hemodialysis (HD ) (n = 44) and peritoneal dialysis (PD) (n = 19). The plasma protein c ontent of the well characterized AGE, pentosidine was measured using H PLC. In the same samples the monocyte activation product neopterin was measured by RIA. Results: Plasma levels of pentosidine and neopterin increased in parallel with the progression of renal failure. Pentosidi ne and neopterin were highly correlated in all patients even after adj ustment for Ccr. This correlation was also present in patients with ES RD. Conclusion: These data suggest that the AGE pentosidine is associa ted with monocyte activation in renal failure, an interaction which ma y contribute to accelerated rates of complication and death by as yet unknown mechanisms.