Two advanced glycation molecules, carboxymethyllysine and pentosidine, and dialysis membrane in dialysis-related amyloidosis

Studies on advanced glycation end products will provide new scientific clues to the pathogenesis of dialysis-related amyloidosis, a crucial problem in dialysis patients. We previously reported our data onN^sup ε^-(carboxymethyl)lysine-hemoglobin from maintenance hemodialysis patients. Further detailed data onN^sup ε^-(carboxymethyl)lysine-hemoglobin and serum pentosidine are presented herein and discussed in relation to dialysis-related amyloidosis and dialysis membranes. Clinical features of dialysis-related amyloidosis and the history of the dialysis membrane used were thoroughly reviewed in 66 patients undergoing hemodialysis. Circulating levels ofN^sup ε^-(carboxymethyl)lysine-hemoglobin were assayed by the dot-blotting method, and serum levels of pentosidine were measured by enzyme-linked immunosorbent assay. Circulating concentrations ofN^sup ε^-(carboxymethyl)lysine-hemoglobin were increased to about twice those present in healthy persons, and serum levels of pentosidine were elevated to as high as 2402.8±1132.1 pmol/ml in 66 patients, as compared with 220.0±39.4 pmol/ml in healthy persons. Circulating levels ofN^sup ε^-(carboxymethyl)lysine-hemoglobin correlated significantly with both the total length of dialysis history and the severity of the clinical features of dialysis-related amyloidosis. On the other hand, serum levels of pentosidine showed no correlation with either of them. These results strongly suggest that cellulosic dialysis membranes have a critical role in the development of dialysis-related amyloidosis. In addition, quite a large difference in the circulating levels of two advanced glycation end-product molecules,N^sup ε^-(carboxymethyl)lysine-hemoglobin and pentosidine, was found in the clinical setting of dialysis, and thus difference deserves further investigation.[PUBLICATION ABSTRACT]