Plasma Pentosidine and Its Association with Mortality in Patients with Chronic Kidney Disease.

Circulating advanced glycated end-products (AGEs) including pentosidine accumulating in chronic kidney disease (CKD) patients due to retention and increased formation are thought to contribute to cardiovascular disease (CVD). Here we evaluated factors linked to increased plasma pentosidine and its a...

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Main Authors: Anna Machowska, Jia Sun, Abdul Rashid Qureshi, Naohito Isoyama, Paul Leurs, Björn Anderstam, Olof Heimburger, Peter Barany, Peter Stenvinkel, Bengt Lindholm
Format: Article
Language:English
Published: Public Library of Science (PLoS) 2016-01-01
Series:PLoS ONE
Online Access:http://europepmc.org/articles/PMC5049770?pdf=render
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author Anna Machowska
Jia Sun
Abdul Rashid Qureshi
Naohito Isoyama
Paul Leurs
Björn Anderstam
Olof Heimburger
Peter Barany
Peter Stenvinkel
Bengt Lindholm
author_facet Anna Machowska
Jia Sun
Abdul Rashid Qureshi
Naohito Isoyama
Paul Leurs
Björn Anderstam
Olof Heimburger
Peter Barany
Peter Stenvinkel
Bengt Lindholm
author_sort Anna Machowska
collection DOAJ
description Circulating advanced glycated end-products (AGEs) including pentosidine accumulating in chronic kidney disease (CKD) patients due to retention and increased formation are thought to contribute to cardiovascular disease (CVD). Here we evaluated factors linked to increased plasma pentosidine and its association with mortality in patients with different stages of CKD and undergoing different treatments.Plasma pentosidine, biomarkers of inflammation, oxidative stress and nutritional status were investigated in CKD 1-2 (n = 37), CKD 3-4 (n = 54), CKD 5 non-dialyzed (CKD5-ND; n = 386), peritoneal dialysis (PD; n = 74) and hemodialysis (HD; n = 195) patients. Factors predicting plasma pentosidine were analysed by multivariate regression analysis and mortality risk was assessed by GENMOD procedure.Plasma pentosidine levels, which were higher in CKD5-ND, PD and HD groups than in CKD 1-2 group, were significantly lower in PD than in HD patients, and not different between PD patients and CKD5-ND patients. Pentosidine associated inversely with glomerular filtration rate (GFR), and additionally in PD with 8-hydroxy-2'-deoxyguanosine (8-OHdG), and interleukin 6 (IL-6); in HD with age, IL-6 and body mass index (BMI); in CKD5-ND with age, 8-OHdG, IL-6, high-sensitive C-reactive protein (hsCRP), and soluble vascular cell adhesion protein-1 (sVCAM-1); in CKD 3-4 with 8-OHdG and sVCAM-1; and in CKD 1-2 with age and sVCAM-1. In multivariate analysis, age (one standard deviation, 1-SD higher), malnutrition (subjective global assessment, SGA), oxidative stress (8-OHdG, 1-SD higher), and belonging to CKD5-ND, HD and PD cohorts associated with 1-SD higher pentosidine. In GENMOD, 1-SD higher pentosidine independently predicted all-cause mortality (relative risk, RR = 1.04; 95% confidence interval, CI, 1.01-1.08, p = 0.01) and CVD mortality (RR = 1.03; 95% CI, 1.01-1.06, p = 0.03) after adjusting for all confounders.Plasma pentosidine is markedly elevated in CKD and associates with low GFR, oxidative stress and inflammation, and is an independent predictor of mortality in CKD patients.
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spelling doaj.art-577c466616dd4eacb7f19b4366f095b52022-12-21T18:45:14ZengPublic Library of Science (PLoS)PLoS ONE1932-62032016-01-011110e016382610.1371/journal.pone.0163826Plasma Pentosidine and Its Association with Mortality in Patients with Chronic Kidney Disease.Anna MachowskaJia SunAbdul Rashid QureshiNaohito IsoyamaPaul LeursBjörn AnderstamOlof HeimburgerPeter BaranyPeter StenvinkelBengt LindholmCirculating advanced glycated end-products (AGEs) including pentosidine accumulating in chronic kidney disease (CKD) patients due to retention and increased formation are thought to contribute to cardiovascular disease (CVD). Here we evaluated factors linked to increased plasma pentosidine and its association with mortality in patients with different stages of CKD and undergoing different treatments.Plasma pentosidine, biomarkers of inflammation, oxidative stress and nutritional status were investigated in CKD 1-2 (n = 37), CKD 3-4 (n = 54), CKD 5 non-dialyzed (CKD5-ND; n = 386), peritoneal dialysis (PD; n = 74) and hemodialysis (HD; n = 195) patients. Factors predicting plasma pentosidine were analysed by multivariate regression analysis and mortality risk was assessed by GENMOD procedure.Plasma pentosidine levels, which were higher in CKD5-ND, PD and HD groups than in CKD 1-2 group, were significantly lower in PD than in HD patients, and not different between PD patients and CKD5-ND patients. Pentosidine associated inversely with glomerular filtration rate (GFR), and additionally in PD with 8-hydroxy-2'-deoxyguanosine (8-OHdG), and interleukin 6 (IL-6); in HD with age, IL-6 and body mass index (BMI); in CKD5-ND with age, 8-OHdG, IL-6, high-sensitive C-reactive protein (hsCRP), and soluble vascular cell adhesion protein-1 (sVCAM-1); in CKD 3-4 with 8-OHdG and sVCAM-1; and in CKD 1-2 with age and sVCAM-1. In multivariate analysis, age (one standard deviation, 1-SD higher), malnutrition (subjective global assessment, SGA), oxidative stress (8-OHdG, 1-SD higher), and belonging to CKD5-ND, HD and PD cohorts associated with 1-SD higher pentosidine. In GENMOD, 1-SD higher pentosidine independently predicted all-cause mortality (relative risk, RR = 1.04; 95% confidence interval, CI, 1.01-1.08, p = 0.01) and CVD mortality (RR = 1.03; 95% CI, 1.01-1.06, p = 0.03) after adjusting for all confounders.Plasma pentosidine is markedly elevated in CKD and associates with low GFR, oxidative stress and inflammation, and is an independent predictor of mortality in CKD patients.http://europepmc.org/articles/PMC5049770?pdf=render
spellingShingle Anna Machowska
Jia Sun
Abdul Rashid Qureshi
Naohito Isoyama
Paul Leurs
Björn Anderstam
Olof Heimburger
Peter Barany
Peter Stenvinkel
Bengt Lindholm
Plasma Pentosidine and Its Association with Mortality in Patients with Chronic Kidney Disease.
PLoS ONE
title Plasma Pentosidine and Its Association with Mortality in Patients with Chronic Kidney Disease.
title_full Plasma Pentosidine and Its Association with Mortality in Patients with Chronic Kidney Disease.
title_fullStr Plasma Pentosidine and Its Association with Mortality in Patients with Chronic Kidney Disease.
title_full_unstemmed Plasma Pentosidine and Its Association with Mortality in Patients with Chronic Kidney Disease.
title_short Plasma Pentosidine and Its Association with Mortality in Patients with Chronic Kidney Disease.
title_sort plasma pentosidine and its association with mortality in patients with chronic kidney disease
url http://europepmc.org/articles/PMC5049770?pdf=render
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