Journal Article

An oral load of the early glycation compound lactuloselysine fails to accumulate in the serum of uraemic patients

Vedat Schwenger, Christian Morath, Kathrin Schönfelder, Wolfgang Klein, Kai Weigel, Reinhold Deppisch, Thomas Henle, Eberhard Ritz and Martin Zeier

in Nephrology Dialysis Transplantation

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

Volume 21, issue 2, pages 383-388
Published in print February 2006 | ISSN: 0931-0509
Published online October 2005 | e-ISSN: 1460-2385 | DOI: http://dx.doi.org/10.1093/ndt/gfi151
An oral load of the early glycation compound lactuloselysine fails to accumulate in the serum of uraemic patients

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Background. It has been hypothesized that in renal failure, exogenous glycation compounds from food accumulate and play a major pathogenetic role when renal excretion is impaired.

Methods. To address this, a diet containing a defined amount of the lysine Amadori product (AP) lactuloselysine was used. Plasma concentrations and cumulative urinary excretion of AP were assessed in 16 healthy subjects, 12 renal failure patients and 6 continuous ambulatory peitoneal dialysis (CAPD) patients. Amadori product was measured as furosine using reverse phase high performance liquid chromatography (RP-HPLC) after acid hydrolysis.

Results. A diet low in glycation compounds significantly decreased excretion of APs in healthy subjects. In healthy individuals, ingestion of lactuloselysine bound to food proteins caused only a minor acute increase (8.24±1.11 mg/day, 2% of the administered dose) of AP excretion in the urine; in patients with renal failure not yet on dialysis, the increase in AP excretion in the urine was significantly less (4.0±0.51 mg/day) and the same was true in CAPD patients (0.21±0.09 mg/day). The plasma concentration of total APs, i.e. the sum of APs as free amino acids and residues bound to plasma proteins, did not change in any of the three groups, however.

Conclusion. Dietary APs do not accumulate in the blood even in advanced renal failure. The amount of APs measured as furosine excreted in the urine is significantly less, however, in renal failure and CAPD patients compared with healthy subjects. Although the findings exclude accumulation of lactuloselysine in renal failure, they do not generally exclude accumulation of other food-derived advanced glycation end products (AGEs).

Keywords: advanced glycation end products (AGEs); furosine; lactuloselysine; nutrition; renal failure

Journal Article.  3297 words.  Illustrated.

Subjects: Nephrology

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