Advanced Glycosylation End Products: Effects in Chronic Kidney Disease and Related Disorders

Chronic kidney disease (CKD) is a clinical condition that can end in endstage renal disease (ESRD) and needs dialysis or a kidney transplant. Hypertension, diabetes, obesity, and cardiovascular risk factors are the main contributing factors to the CKD process. One of the factors with exogenous and endogenous sources affecting the CKD progression or prognosis and its complications is the accumulation of advanced glycosylation end products (AGEs) through the glycosylation of proteins, lipids, or nucleic acids or by dietary sources. AGEs accumulationcan adversely affect the long-term complications of diabetic patient such as nephropathy or retinopathy, especially in those with type 2 diabetes. These compounds can affect cardiovascular health by inducing cardiomyopathy and congestive heart failure. Dialysis patients are among those with higher oxidative stress and lipid peroxidation which can affect the levels of AGEs in these patients. Lower clearance or excretion of the AGEs through kidneys and higher dietary absorption can cause higher levels of AGEs in this population. Higher AGEs are accompanied byhigher rates of CVD, connective tissue disorders, mortality and lower quality of life in CKD patients. Dietary modifications are considered one of the main factors affecting the levels of AGEs in CKD patients which can improve their prognosis and complications even in the absence of diabetes. The ways of cooking and the ingredients focusing on reducing the temperature, cooking time, moist heat, and using acidic ingredients such as lemon juice or using anti-AGE compounds are recommended for reducing AGEs formation in foods.