GDPs and AGEs: impact on cardiovascular toxicity in dialysis patients

Glucose degradation products (GDPs) are highly reactive precursors of advanced glycation end-products (AGEs). High glucose concentrations, GDPs, and AGEs can activate specific pathways, including inflammatory and oxidative stress response pathways, which may adversely affect the cardiovascular system. This review discusses the impact and possible mechanisms of action of GDPs and AGEs with regard to cardiovascular toxicity in chronic kidney disease patients. The AGE-RAGE pathway appears to be particularly important in the pathogenesis of cardiovascular diseases in dialysis patients. In the absence of definitive proof from randomized controlled trials, mounting evidence suggests that high levels of GDPs and AGEs play a role in the pathophysiology of cardiotoxicity.