3-Deoxyglucosone, a promoter of advanced glycation end products in fluids for peritoneal dialysis

The accumulation of irreversible formed advanced glycosylation end products (AGE) in the peritoneal cavity might play an important role in the development of ultrafiltration failure and peritoneal membrane destruction. 3-Deoxyglucosone (3-DG), more formally named 3-deoxy-D-erythro-hexos-2-ulose or 3-deoxy-D-erythro-hexosulos is known to be a potent cross-linker responsible for the polymerization of proteins and a precursor of AGE. The purpose of the present study was to determine if the dicarbonyl compound 3-DG, is formed as a glucose degradation product during heat sterilization of fluids for peritoneal dialysis (PD).

Four fluids were examined: a commercially available PD fluid Gambrosol (Gambro, Lund, Sweden); Gambrosol-Bio (Gambro), a new PD-fluid produced under conditions that minimize the generation of toxic glucose degradation products; a fluid prepared in the laboratory by sterile-filtration; and a fluid prepared in the laboratory by heat sterilization.

The concentration of 3-DG was analyzed by measuring the concentration of its diaminonaphthalene derivative by HPLC using a Waters Symmetry C18 column.

The 3-DG concentrations in the commercially- and laboratory-prepared heat-sterilized fluids were 118 and 154 micromol/L, respectively. Gambrosol-Bio and the sterile-filtered fluid produced in the laboratory contained 3-DG in concentrations of 12.3 and less than 1.2 micromol/L, respectively.

Our results demonstrate that during the heat sterilization of conventional PD-fluids, 3-DG is produced as a degradation product of glucose. It was also demonstrated that, through an alteration of the manufacturing condition, the production of 3-DG could be considerably reduced. We speculate that the presence of 3-DG in unused conventional PD-fluid could act as a local promoter, and increase local AGE formation within the peritoneal cavity.