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Advanced glycation end products in children with chronic renal failure and type 1 diabetes

Joachim Misselwitz1, Sybille Franke, Eberhard Kauf

  • 1Klinikum der FSU, Klinik für Kinder- und Jugendmedizin, Kochstrasse 2, 07745 Jena, Germany. joachim.misselwitz@med.uni-jena.de

Pediatric Nephrology (Berlin, Germany)
|June 4, 2002
PubMed

Insights

Serum levels of advanced glycation end products (AGEs) are elevated in children with chronic renal failure (CRF) and type 1 diabetes. Levels normalize after kidney transplant, highlighting its importance and the need for metabolic monitoring in diabetics.

Area of Science:

  • Pediatric Nephrology
  • Endocrinology
  • Metabolic Diseases

Background:

  • Advanced glycation end products (AGEs) accumulate in adults with chronic renal failure (CRF) and diabetes, contributing to long-term complications.
  • Knowledge regarding AGE formation in childhood remains limited.
  • This study investigates AGEs in pediatric populations with kidney disease and diabetes.

Purpose of the Study:

  • To determine serum levels of pentosidine and Nε-carboxymethyllysine (CML) in children with CRF, end-stage renal disease (ESRD), post-renal transplantation, and type 1 diabetes mellitus.
  • To compare these levels with healthy children.
  • To explore the relationship between AGEs and renal function.

Main Methods:

  • Serum pentosidine measured by high-performance liquid chromatography (HPLC).
  • Serum Nε-carboxymethyllysine (CML) measured by competitive enzyme-linked immunosorbent assay (ELISA).
  • Comparison of AGE levels across patient groups and healthy controls.

Main Results:

  • Significantly higher serum pentosidine and CML in children with CRF and ESRD compared to controls (P<0.001).
  • AGE levels were near normal post-renal transplantation.
  • Both AGEs negatively correlated with creatinine clearance (P<0.001).
  • Hemodialysis did not alter total AGE levels, but reduced free pentosidine by 78% (P=0.04).
  • Diabetic children had elevated pentosidine despite normal renal function (P<0.001).

Conclusions:

  • Children with CRF and type 1 diabetes exhibit increased AGE formation and accumulation, similar to adults.
  • Early renal transplantation is crucial for preventing AGE-related complications in pediatric ESRD.
  • Careful metabolic monitoring is essential for diabetic children to manage AGEs.

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