Immunohistochemical detection of advanced glycosylation endproducts in the peritoneum and its possible pathophysiological role in CAPD

It has recently bern suggested that advanced glycosylation end-products (AGEs) ars formed in the peritoneum in patients on CAPD. However. the exact location of AGE accumulation, thr relation with the duration of CAPD and its pathophysiological role in CAPD remain unclear. If the peritoneum is glycosylated, it could bring about altered peritoneal function. Therefore, the aim of this study is to clarify thr: localization of AGEs in the peritoneum in accordance with the duration of CAPD and to examine its relation to thr peritoneal permeability. Fifteen non-diabetic patients were divided into three groups (each patients) on the basis of the mean duration (D) of CAPD (Group I, D = 0 month: Group II, D = 34 months: Group III, D = 84 months). The AGE staining by monoclonal anti-AGE antibody in thr peritoneum and the four-hour peritoneal equilibration test (PET) were compared among these groups. AGE was absent or found only weakly in Group I. However, in groups II and III. AGE was moderately or strongly positive especially in the vascular walls and it was dominant in group III. PET revealed that peritoneal permeability for glucose, creatinine, beta(2)-microglobulin and albumin was increased in Group II as compared to Group I, and it was further increased in Group III. The results of this study indicate that AGEs become dominantly accumulated in thr vascular wall in accordance with thr prolongation of CAPD treatment, and this might play some roles for the increased permeability of the peritoneal membrane in CAPD.