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Nephrol Dial Transplant (2001) 16: 999-1008
© 2001 European Renal Association-European Dialysis and Transplant Association

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

Günter Stein1,, Sybille Franke1, Arezki Mahiout2, Sabine Schneider3, Heide Sperschneider1, Sabine Borst4 and Jörg Vienken4

1 Department of Internal Medicine IV, Friedrich Schiller University of Jena, Germany, 2 Institute of Cell and Protein Engineering, Medical Park Hannover, Germany, 3 Kuratorium für Dialyse und Nierentransplantation, Jena, Germany and 4 Fresenius Medical Care, Bad Homburg, Germany

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-ß2-microglobulin and ß2-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-ß2-microglobulin 64.0±16.5 vs 45.4±17.7%; ß2-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-ß2-microglobulin concentrations decreased insignificantly, whereas those of ß2-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

Correspondence and offprint requests to: Prof. Dr G. Stein, Department of Internal Medicine IV, Erlanger Allee 101, D-07740 Jena, Germany.


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