3-Deoxyglucosone, a promoter of advanced glycation end products in fluids for peritoneal dialysis.

OBJECTIVE: The accumulation of irreversible formed advanced glycosylation end products (AGE) in the peritoneal cavity might play an important role in the development of ultrafiltration failure and peritoneal membrane destruction. 3-Deoxyglucosone (3-DG), more formally named 3-deoxy-D-erythro-hexos-2-ulose or 3-deoxy-D-erythro-hexosulos is known to be a potent cross-linker responsible for the polymerization of proteins and a precursor of AGE. The purpose of the present study was to determine if the dicarbonyl compound 3-DG, is formed as a glucose degradation product during heat sterilization of fluids for peritoneal dialysis (PD).
DESIGN: Four fluids were examined: a commercially available PD fluid Gambrosol (Gambro, Lund, Sweden); Gambrosol-Bio (Gambro), a new PD-fluid produced under conditions that minimize the generation of toxic glucose degradation products; a fluid prepared in the laboratory by sterile-filtration; and a fluid prepared in the laboratory by heat sterilization.
METHODS: The concentration of 3-DG was analyzed by measuring the concentration of its diaminonaphthalene derivative by HPLC using a Waters Symmetry C18 column.
RESULTS: The 3-DG concentrations in the commercially- and laboratory-prepared heat-sterilized fluids were 118 and 154 micromol/L, respectively. Gambrosol-Bio and the sterile-filtered fluid produced in the laboratory contained 3-DG in concentrations of 12.3 and less than 1.2 micromol/L, respectively.
CONCLUSION: Our results demonstrate that during the heat sterilization of conventional PD-fluids, 3-DG is produced as a degradation product of glucose. It was also demonstrated that, through an alteration of the manufacturing condition, the production of 3-DG could be considerably reduced. We speculate that the presence of 3-DG in unused conventional PD-fluid could act as a local promoter, and increase local AGE formation within the peritoneal cavity.