Serum carboxymethyllysine predicts mortality in hemodialysis patients

Zoltán Wagner, Márta Molnár, Gergö A. Molnár, Mónika Tamaskó, Boglárka Laczy, László Wagner, Botond Csiky, August Heidland, Judit Nagy, István Wittmann

Research output: Contribution to journalArticle

67 Citations (Scopus)

Abstract

• Background: Hemodialysis patients show markedly elevated serum levels of advanced glycation end products (AGEs). AGEs have been implicated in the pathogenesis of vascular damage and are regarded as a class of uremic toxins. However, to date, serum AGE level could not be identified as an independent predictor of mortality. The aim of the present study is to test whether serum level of the AGE carboxymethyllysine (CML) predicts all-cause or cardiovascular mortality in hemodialysis patients. Methods: Serum total CML concentration was measured by means of enzyme-linked immunosorbent assay in 154 patients receiving long-term hemodialysis. Patients were divided into groups with serum CML levels less and greater than the median (23.8 ng/mg protein). All-cause and cardiovascular mortality were registered during a follow-up of 51 months. The relationship between serum CML level and mortality was tested by using Kaplan-Meier and Cox regression analyses. Results: In the group with low serum CML levels, 38% of patients died during the follow-up period; 23% had a cardiovascular cause of death. However, in the group with high CML levels, 58% died (P < 0.01) and 36% had a cardiovascular cause of death (P < 0.05). The following parameters proved to be independent risk factors of all-cause mortality: age (hazard ratio, 1.056; P < 0.001), preexisting vascular disease (hazard ratio, 2.53; P < 0.05), smoking (hazard ratio, 3.03; P < 0.005), high serum CML level (hazard ratio, 1.776; P < 0.05), and C-reactive protein level (hazard ratio, 1.017; P < 0.001). Conclusion: The AGE CML may contribute to increased mortality in patients with uremia.

Original languageEnglish
Pages (from-to)294-300
Number of pages7
JournalAmerican Journal of Kidney Diseases
Volume47
Issue number2
DOIs
Publication statusPublished - Feb 1 2006

Keywords

  • Advanced glycation end products
  • Carboxymethyllysine
  • Hemodialysis (HD)
  • Mortality
  • Uremia

ASJC Scopus subject areas

  • Nephrology

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