FP255
RENAL DYSFUNCTION INDEPENDENTLY RELATES TO INCREASED BIOLOGICAL CARBONYL STRESS

Introduction and Aims: Intermediate carbonyls and advanced glycation end products (AGEs) are thought to be related to the development of complications of patients with chronic kidney diseases. Especially, Nε-(carboxymethyl) lysine (CML) has been primarily studied in persons with diabetes or end-stage renal disease as a modifiable risk factor of renal disease. However, each AGE is known to contribute to the different pathology, and the pathophysiology of another AGE is still unclear. The objective is to characterize the relationship between AGEs and renal function, especially in terms of Nδ-(5-hydro-5-methyl-4-imidazolon-2-yl)-ornithine (MG-H1) level as a biomarker of carbonyl stress.

Methods: The total of 50 patients who admitted in our hospital between April and November 2014 was enrolled in this study (33 men and 17 women, average age: 60.9 years; range 19-88 years). Patients who received corticosteroid and renal replacement therapies were excluded from the analysis. Serum levels of CML and MG-H1, the predominant AGEs, were measured by using liquid chromatography - tandem mass spectrometry, and subjected to a cross-sectional analysis to determine their correlation correlated with renal function.

Results: CML and MG-H1 levels were correlated with renal dysfunction status (Spearman rank correlation coefficient: CML vs. estimated glomerular filtration rate [eGFR], r = -0.784, p < 0.01; MG-H1 vs. eGFR, r = -0.691, p < 0.01). In the multivariate logistic regression analysis, advanced renal failure (eGFR < 30mL/min/1.73m2) was associated with higher serum CML levels (higher than the median; odds ratio [OR], 54.43; 95% confidence interval [CI], 5.83-446.55; p < 0.01) after adjusting for age, diabetes mellitus (DM), and systolic blood pressure. Advanced renal failure was also associated with higher serum MG-H1 levels (higher than the median; OR, 20.44; 95% CI, 3.89-107.49; p < 0.01) after adjusting for age, DM, systolic blood pressure, and a history of cardiovascular disease.

Conclusions: Renal dysfunction is strongly associated with serum MG-H1 as well as serum CML. In future, we attempt to clarify what clinical condition MG-H1 is linked to in patients with chronic kidney disease.