Methylglyoxal as a prognostic factor in patients with chronic kidney disease. Issue 9 (29th April 2019)

• Record Type: Journal Article
• Authors: Tezuka, Yuta; Nakaya, Izaya; Nakayama, Keisuke; Nakayama, Masaaki; Yahata, Mayumi; Soma, Jun
• Is Part Of: Nephrology. Volume 24:Issue 9(2019)
• Page Start: 943
• Page End: 950
• Publication Date: 2019-04-29
• Subjects: advanced glycation end products -- cardiovascular disease -- chronic kidney disease -- end‐stage kidney disease; Nephrology -- Periodicals; Kidneys -- Diseases -- Periodicals; Nephrologists -- Periodicals; 616.61; 616.61
• DOI: 10.1111/nep.13526
• Languages: English
• ISSNs: 1320-5358

Abstract

ABSTRACT: Aim: Advanced glycation end products and their precursors cause vascular damage through oxidative stress. We investigated the hypothesis that methylglyoxal (MG), 3‐deoxyglucosone (3‐DG) and pentosidine influence outcomes of chronic kidney disease (CKD) patients. Methods: We conducted a 3 years prospective observational study involving 150 outpatients at CKD stages 3–5. At enrolment, MG, 3‐DG and pentosidine plasma concentrations were measured; patients were divided into tertiles according to the concentration of each substance. The primary endpoint was death, a cardiovascular event or end‐stage renal disease. Survival analysis was performed using the Cox regression model. Results: The patients' mean age was 62 ± 12 years, 97 were men, and 20 had diabetic nephropathy. The mean estimated glomerular filtration rate was 25.0 ± 12.1 mL/min per 1.73 m 2, which negatively correlated with MG but not with 3‐DG and pentosidine. Forty‐eight patients reached the primary endpoint. Compared with the lowest MG tertile, the hazard ratio for the primary endpoint was 7.57 (95% confidence interval (CI): 1.71–33.54) in the middle tertile and 27.00 (CI: 6.46–112.82) in the highest tertile. When adjusted for characteristics at baseline, the corresponding hazard ratio decreased to 2.09 (CI: 0.37–11.96) and 6.13 (CI: 0.97–38.82), but MG tertile remained an independent risk factor for the primary endpoint. However, 3‐DG and pentosidine were not related to the primary outcome. Conclusion: Methylglyoxal has a close clinical association with CKD. Higher MG concentrations may contribute renal function deterioration in CKD. In CKD patients, MG concentration might be useful when determining the prognosis. SUMMARY AT A GLANCE: Higher plasma concentrations of methylglyoxal (MG), a marker of oxidative stress, were shown to correlate with the development of end‐stage kidney disease in patients with chronic kidney disease (CKD), especially those with diabetic kidney disease (DKD). MG may be a biomarker for progressive CKD and especially DKD.