IMMUNOHISTOCHEMICAL STUDY OF HUMAN ADVANCED GLYCOSYLATION END-PRODUCTS (AGE) IN CHRONIC-RENAL-FAILURE

In patients with diabetic renal failure plasma advanced glycosylation end-products (AGE) levels are reported to be elevated and dialyzer of continuous ambulatory peritoneal dialysis (CAPD) is usually used with a high glucose concentration. Here, an immunohistochemical study on hu man AGE accumulation in vascular beds and peritonea of patients with c hronic renal failure (CRF) or those on CAPD was undertaken. Further, t he influence of aging was studied using AGE-specific monoclonal antibo dy. 1. AGE accumulation was observed in radial arterial walls (from va scular intima to smooth muscle layer) of diabetic patients with CRE Ev en in some non-diabetic patients with CRF (n = 3/6), especially in tho se with a long history of CRF and dialysis treatment, similar positive staining was seen in vascular walls. No AGE staining was observed in any renal tissue of age-matched control subjects including tissue from patients with acute renal failure. 2. Although AGE accumulation was n ot seen in the peritonea of CRF patients with no prior CAPD therapy, i t was seen in the mesothelial layers and in adjacent coarse connective tissues of peritonea from patients on CAPD (n = 6), even from as earl y as only 3 months of CAPD therapy. 3. AGE accumulation was observed i n the vascular bed of the non-diabetic aged kidney with normal functio n, but not in that of the young kidney. Thus, AGE accumulation in the vascular bed may depend on the degree and term of renal impairment and on aging in addition to diabetes. AGE accumulation in the peritonea b ecame positive following CAPD treatment, indicating that it might affe ct the efficiency of CAPD.