High plasma pentosidine level is accompanied with cardiovascular events in hemodialysis patients

Cardiovascular disease is a major complication in patients with end-stage renal disease (ESRD). The accumulation of advanced glycation end products (AGEs) is facilitated in these patients. The aim of this study was to investigate the relationship between circulating AGEs and cardiovascular events in hemodialysis patients. The plasma level of pentosidine, a well-defined AGEs, was measured in 110 hemodialysis patients who were prospectively followed for 90 months. The relationship between plasma pentosidine level and cardiovascular events was assessed using Kaplan-Meier and Cox regression analysis. Thirty-nine cardiovascular events (14 coronary heart disease and 25 strokes) occurred during the follow-up period. Multivariable Cox proportional hazard analysis showed that plasma pentosidine levels (HR 1.040, 95% CI 1.022-1.058, p < 0.01) were correlated to increased risk for cardiovascular events. When patients were divided into four groups according to plasma pentosidine levels, Kaplan-Meier analysis revealed that cardiovascular events in the highest pentosidine group were significantly greater than in the other groups (p < 0.01 in lower and low, and p < 0.05 in high pentosidine groups). The plasma pentosidine level predicts cardiovascular events in hemodialysis patients. The effects of lowering circulating AGE levels on cardiovascular events should be examined in ESRD patients.