Journal Article

Influence of dialysis modalities on serum AGE levels in end‐stage renal disease patients

Günter Stein, Sybille Franke, Arezki Mahiout, Sabine Schneider, Heide Sperschneider, Sabine Borst and Jörg Vienken

in Nephrology Dialysis Transplantation

Published on behalf of European Renal Association - European Dialysis and Transplant Assoc

Volume 16, issue 5, pages 999-1008
Published in print May 2001 | ISSN: 0931-0509
Published online May 2001 | e-ISSN: 1460-2385 | DOI: http://dx.doi.org/10.1093/ndt/16.5.999
Influence of dialysis modalities on serum AGE levels in end‐stage renal disease patients

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Backround. The accumulation of advanced glycation end‐products (AGEs) in end‐stage renal disease (ESRD) influenced by dialysis modalities is of current interest. Highly permeable membranes in haemodialysis or haemofiltration should be able to eliminate circulating AGEs as well as their AGE precursors more efficiently.

Methods. In our study, 10 non‐diabetic and 10 diabetic ESRD patients were on haemodialysis with low‐flux membranes (LF) followed by a cross‐over haemodialysis with high‐flux or super‐flux polysulfone membranes (HF, SF) for 6 months each. We measured the protein‐bound pentosidine and free pentosidine serum levels by high‐performance liquid chromatography (HPLC) as well as the serum AGE peptide, AGE‐β2‐microglobulin and β2‐microglobulin concentrations, using ELISA assays.

Results. All parameters investigated were significantly higher in dialysis patients than in healthy subjects. The reduction rates during a single dialysis session were found to be higher using the SF than those obtained with the HF (free pentosidine 82.4±7.3 vs 76.6± 8.7%; AGE peptides 79.7±7.7 vs 62.3±14.7%; AGE‐β2‐microglobulin 64.0±16.5 vs 45.4±17.7%; β2‐microglobulin 70.5±5.6 vs 58.2±6.0%). The protein‐bound pentosidine levels remained constant over the respective dialysis sessions. In the 6‐month treatment period with the SF, decreased pre‐dialysis serum levels of protein‐bound pentosidine, free pentosidine and AGE peptides were observed in non‐diabetics and diabetics as compared with values obtained with the LF. The respective pre‐dialysis AGE‐β2‐microglobulin concentrations decreased insignificantly, whereas those of β2‐microglobulin were significantly lower. Using the HF dialyser, only moderate changes of the parameters measured were noted.

Conclusion. Treatment with the biocompatible polysulfone SF dialyser seems to be better suited to lower serum AGE levels and to eliminate their precursors.

Keywords: advanced glycation end‐products; haemodialysis; high‐flux polysulfone

Journal Article.  4227 words.  Illustrated.

Subjects: Nephrology

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