IMMUNOHISTOCHEMICAL DETECTION OF ADVANCED GLYCOSYLATION ENDPRODUCTS IN THE PERITONEUM AND ITS POSSIBLE PATHOPHYSIOLOGICAL ROLE IN CAPD

It has recently bern suggested that advanced glycosylation end-product s (AGEs) ars formed in the peritoneum in patients on CAPD. However. th e exact location of AGE accumulation, thr relation with the duration o f CAPD and its pathophysiological role in CAPD remain unclear. If the peritoneum is glycosylated, it could bring about altered peritoneal fu nction. Therefore, the aim of this study is to clarify thr: localizati on of AGEs in the peritoneum in accordance with the duration of CAPD a nd to examine its relation to thr peritoneal permeability. Fifteen non -diabetic patients were divided into three groups (each patients) on t he basis of the mean duration (D) of CAPD (Group I, D = 0 month: Group II, D = 34 months: Group III, D = 84 months). The AGE staining by mon oclonal anti-AGE antibody in thr peritoneum and the four-hour peritone al equilibration test (PET) were compared among these groups. AGE was absent or found only weakly in Group I. However, in groups II and III. AGE was moderately or strongly positive especially in the vascular wa lls and it was dominant in group III. PET revealed that peritoneal per meability for glucose, creatinine, beta(2)-microglobulin and albumin w as increased in Group II as compared to Group I, and it was further in creased in Group III. The results of this study indicate that AGEs bec ome dominantly accumulated in thr vascular wall in accordance with thr prolongation of CAPD treatment, and this might play some roles for th e increased permeability of the peritoneal membrane in CAPD.