*2.6. Advanced Glycation end Products*

The soluble receptor for advanced glycation end-products (sRAGE) seems to play an important role in cardiac remodeling in CKD patients. sRAGE has been described as a prognostic factor for mortality in diabetic dialysis patients [43,44]. Elevated sRAGE concentrations could represent a protective mechanism against the increased risk of cardiovascular complications resulting from AGEs and inflammation, although the underlying mechanisms need to be further confirmed [45]. It has also been shown that AGEs are involved in the upregulation of fibroblast growth factor 23 (FGF23).

In addition, cardiomyocytic FGF23 expression has been shown to be induced by activated reninangiotensin aldosterone system (RAAS) [46]. In turn, FGF23-mediated activation of local RAAS in the heart promotes cardiac hypertrophy and fibrosis [47]. This finding underlines the organ crosstalk between the kidney and heart in CKD-CVD.
