Nakayama M, Kubo H, Ogawa A, Yamamoto Y, Kato N, et al
Immunohistochemical detection of advanced glycation end-
products (AGEs) in the peritoneum and its possible
pathophysiological role in CAPD
XVIth Annual CAPD Conference
Perit Dial Int Suppl 2
(Feb) 16:S95 1996
The presence of high glucose concentrations in the peritoneal cavity may lead
to increased
expression of advanced glycation end-products (AGE) in peritoneal tissue. In
this study, peritoneal
biopsy samples from 17 non-diabetic patients receiving CAPD were stained for
AGE by using an
anti-AGE monoclonal antibody. The authors also examined the peritoneal
permeability by PET. In
those patients with low average PET there was little AGE staining whereas in
those with high average to high PET there was increased staining for
AGEs in the peritoneal vasculature. The authors propose that increased AGE
staining in the vascular
wall of patients with high peritoneal permeability may play a causative role
in their increased
transport rates.
Comment: This is an interesting study which looks at the effect of
AGEs on vascular
permeability. AGEs are important factors in diabetics for the promotion of
atherosclerosis and
progression of diabetic renal disease as well as retinopathy. It will be
interesting to examine the
role of aminoguanidine in prevention of AGE formation in CAPD patients. This
study is slightly
flawed in that no mention was made of the occurrence of peritonitis, since
there is some human and
animal work suggesting that loss of the mesothelium may allow the formation
of AGE in the
submesothelial areas in the peritoneum.
(James L. Winchester, M.D.)
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XVIth Annual CAPD Conference
Basic peritoneal dialysis :
PET testing