Serum levels of advanced glycoxidation end products (AGE) are elevated in diabetes, renal failure and advanced age and these compounds are thought to mediate, at least in part, many of the vascular complications associated with these conditions. AGEs are a heterogeneous group of compounds formed from the non-enzymatic reaction of reducing sugars with the free amino groups of proteins. It had been assumed that circulating AGE originate exclusively from endogenous sources but now it has become clear that foods contain a variable amount of pre-formed AGE and AGE-precursors that contribute to the body AGE pool.We have recently demonstrated that serum AGE levels correlate with dietary AGE content in ESRD patients on dialysis. When a subgroup of these patients was randomized to follow a diet low in AGE content for 4 weeks, we observed 30% of decrease of serum AGE levels and parallel changes in CRP levels. These studies suggest that dietary AGEs play an important role in determining the body AGE pool and that dietary AGE modulation is a feasible, safe and effective way to decrease body AGE pool. Our working hypothesis is that AGEs represent independent risk factors for cardiovascular disease in renal failure patients. Our next research phase will try to demonstrate in a larger number of patients that low AGE diet can reduce serum AGE levels and at the same time improve the direct markers of vascular structure and function: brachial artery dilatation in response to hyperemia and arterial stiffness.

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