Advanced Glycation End-products, Inflammation and Vascular Health in Chronic Kidney Disease

Advanced glycation end-products (AGEs) are compounds that form when sugars abnormally attach
to proteins or lipids. High levels of AGEs in the blood may cause inflammation, problems
with controlling blood sugar, and problems with the health of blood vessels. Many of the
foods we commonly eat have high amounts of AGEs, which may increase AGEs in the blood of
people with kidney disease. The amount of AGEs in foods can be lowered when prepared using
special cooking techniques such as using moist heat or longer cooking times at lower
temperatures. New research has shown that preparing food in this way can lower inflammation
and improve blood vessel health in people with normal kidney function.

In this study, the investigators would like to examine the effect of lowering the AGE
content of foods on inflammation, blood sugar control, and blood vessel health in
individuals with mild to moderate chronic kidney disease.

Inclusion Criteria:

- Patients with mild to moderate CKD (estimated glomerular filtration rate 15 - 59
ml/min/1.73m2).

Exclusion Criteria:

- Current or past use of anti-glycemic medications

- Fasting glucose > 126 mg/dl on screening visit or positive glucose on urine
dipstick

- Nephrotic-range proteinuria (≥ 3.5 grams per day as assessed by a spot urine albumin
to creatinine ratio obtained at the screening visit)

- Pregnancy or breast-feeding

- Clinical need for a specialized diet (low sodium, low potassium, etc.) or religious
dietary restrictions.

- New or recent change (< 3 months) in dosage of medications known to affect vascular
reactivity— angiotensin converting enzyme inhibitors, angiotensin II receptor
blockers, beta-blockers, calcium channel blockers, HMG-CoA reductase inhibitors, etc.

- Current smoking or recent (< 6 months) cessation of smoking.

- Poorly controlled hypertension (≥ 140 mm Hg systolic or 90 mm Hg diastolic), or prior
history of malignant hypertensive episode (SBP > 200) off of blood pressure
medications.

- Participants with rapidly advancing renal failure.

- Severe anemia, defined as a hemoglobin < 8 g/dL for men and < 6 g/dL for women.