CEN Case Reports

, Volume 7, Issue 1, pp 48–54 | Cite as

AGEs–RAGE overexpression in a patient with smoking-related idiopathic nodular glomerulosclerosis

  • Nao Nakamura
  • Kensei Taguchi
  • Yoshihiro Miyazono
  • Keiichiro Uemura
  • Kiyomi Koike
  • Yuka Kurokawa
  • Yosuke Nakayama
  • Yusuke Kaida
  • Ryo Shibata
  • Akihiro Tsuchimoto
  • Katsuhiko Asanuma
  • Kei Fukami
Case Report

Abstract

We report a case of smoking-related idiopathic nodular glomerulosclerosis (ING) with overexpression of glomerular advanced glycation end products (AGEs) and their receptor (RAGE). A 59-year-old Japanese man with nephrotic syndrome, who had a smoking history of one pack of cigarettes per day for approximately 40 years, presented with a 3-year history of urinalysis abnormalities without clinical evidence of diabetic mellitus. The patient’s leg edema progressively worsened over the previous 2 years, and he was admitted to our hospital. Renal biopsy showed mesangial expansion with diabetic Kimmelstiel–Wilson-like nodular lesions, glomerular basement thickening, and arteriosclerosis. No electron-dense deposits, fibrils, or microtubule deposits were seen in the glomeruli on electron microscopy. Skin AGE level measured using AGE reader was higher in this case than the average level in age-matched Caucasians. In addition, immunohistochemical analysis revealed that N-carboxymethyl lysine, one of the major AGEs, and RAGE were overexpressed and podocin expression was decreased in the peripheral area of the glomerular nodular lesions. These observations suggest that AGEs–RAGE system may be activated in smoking-related ING, possibly leading to the progression of renal dysfunction.

Keywords

Idiopathic nodular glomerulosclerosis Cigarette smoking Hypertension Advanced glycation end products RAGE 

Notes

Acknowledgements

The authors would like to thank the members of the Kyusyu Okinawa Kidney Biopsy forum for their useful discussion. The authors also would like to thank Enago (http://www.enago.jp) for English language review.

Compliance with ethical standards

Informed consent

Informed consent was obtained from the patient in this study.

Conflict of interest

The authors declare that no conflict of interest exists.

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Copyright information

© Japanese Society of Nephrology 2017

Authors and Affiliations

  • Nao Nakamura
    • 1
  • Kensei Taguchi
    • 1
  • Yoshihiro Miyazono
    • 2
  • Keiichiro Uemura
    • 2
  • Kiyomi Koike
    • 3
  • Yuka Kurokawa
    • 1
  • Yosuke Nakayama
    • 1
  • Yusuke Kaida
    • 1
  • Ryo Shibata
    • 1
  • Akihiro Tsuchimoto
    • 4
  • Katsuhiko Asanuma
    • 5
  • Kei Fukami
    • 1
  1. 1.Division of Nephrology, Department of MedicineKurume University School of MedicineKurumeJapan
  2. 2.Division of Microscopic and Developmental Anatomy, Department of AnatomyKurume University School of MedicineKurumeJapan
  3. 3.Division of NephrologyJapanese Red Cross Nagoya Daini HospitalNagoyaJapan
  4. 4.Department of Medicine and Clinical Science, Graduate School of Medical SciencesKyushu UniversityFukuokaJapan
  5. 5.Department of NephrologyChiba University Graduate School of MedicineChibaJapan

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