Methylglyoxal as a Prognostic Factor in Patients with Chronic Kidney Disease.

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 three-year prospective observational study involving 150 outpatients at CKD stages 3-5. At enrollment, 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/1.73 m2 , 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 (HR) 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 HRs decreased to 2.09 (CI: 0.37-11.96) and 6.13 (CI: 0.97-38.82), but MG remained an independent risk factor for the primary endpoint. However, 3-DG and pentosidine were not related to the primary outcome.

CONCLUSIONS: MG 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. This article is protected by copyright. All rights reserved.