Creatinine oxidative metabolites in patients with renal impairment under oxygen stress conditions

Two known toxic creatinine metabolites namely creatol (CTL) andmethylguanidine (MG), are relatively newly discovered guanidinocompounds, produced from creatinine by the oxidation process with areactive oxygen species most probably the hydroxyl radical (OH), i.ecreatinine converted to CTL and CTL hydrolysed to more toxic metabolite(MG).Both CTL and MG could not be determined in physiological fluids bythe conventional guanidine-compound analyzer, due to poor reactivity anddelectability, so need a modified HPLC system, aiming to increasing thesensitivity and delectability to more than 50 fold in physiological fluids.Factors which promote the production of MG from creatinine orcreatol are considered as renal function deteriorating factors. Reactiveoxygen species particularly (OH) radical participates in the pathogenesisof various renal diseases which begins with inflammation and ends withend stage renal disease, these reactive oxygen species, including superoxideanion radical, hydrogen peroxide and hydroxyl radical (OH) may begenerated by activated neotrophils, monocytes and mesagial cells duringthe metabolic processes.Hyperglycemia is the main metabolic problem that causingirreversible kidney damage in diabetic patients, with acceleration of nonenzymaticglycosylation and deposition of AGEs, contributing to thepathogenesis of cor-morbid complications (mainly diabetic ESRD). Theseverity and duration of hyperglycaemia, (uncontrolled n.M) rather thandiabetes type, determine the extent of vasculopathic and renalcomplications of diabetes.