Serum Carboxymethyl-Lysine, a Dominant Advanced Glycation End Product, Is Associated With Chronic Kidney Disease: The Baltimore Longitudinal Study of Aging
published online 23 October 2009.
Objective
Advanced glycation end products (AGEs) are modifiable risk factors for renal disease that were primarily studied in persons with diabetes or endstage renal disease. Our objective was to characterize the relationship between AGEs and renal function in community-dwelling adults.
Design
The presence of serum L-carboxymethyl-lysine (CML), a dominant AGE, was compared with renal function in a cross-sectional analysis.
Setting
This study was part of the Baltimore Longitudinal Study of Aging in Baltimore, Maryland.
Patients or Other Participants
Participants included community-dwelling men and women, aged 26 to 93 years, seen during a regular follow-up visit to the Baltimore Longitudinal Study of Aging between 2002 and 2007.
Main Outcome Measures
The main outcome measures included chronic kidney disease (CKD) at stage ≥3 of the National Kidney Foundation classification (estimated glomerular filtration rate [eGFR] of<60 mL/minute/1.73 m2) and eGFR.
Results
Of 750 adults, 121 (16.1%) had CKD. Serum CML was associated with CKD (odds ratio expressed per one standard deviation, 1.37; 95% confidence interval, 1.11 to 1.67; P=.003) in a multivariate logistic regression model adjusting for age, race, smoking, and chronic diseases. Serum CML was associated with eGFR (mL/minute/1.73 m2) (β=−2.21, standard error=0.57, P=.0001) in a multivariate linear regression model, adjusting for age, race, smoking, and chronic diseases. After excluding patients with diabetes, serum CML was associated with CKD (odds ratio per one standard deviation, 1.38; 95% confidence interval, 1.12 to 1.70; P=.003) and eGFR (β=−2.09, standard error=0.59, P=.0005), adjusting for the same covariates.
Conclusion
Serum CML, a dominant AGE, is independently associated with CKD and eGFR.
∗Department of Ophthalmology, Johns Hopkins University School of Medicine, Baltimore, Maryland
†Division of Nephrology, Department of Medicine, University of Maryland School of Medicine, Baltimore, Maryland
‡Longitudinal Studies Section, Clinical Research Branch, National Institute on Aging, Baltimore, Maryland
Address reprint requests to Richard Semba, MD, MPH, Department of Ophthalmology, Johns Hopkins University School of Medicine, 550 N. Broadway, Suite 700, Baltimore, MD 21205.
ABSTRACT