Changes in Urinary Methylguanidine in Cases with End-Stage Renal Disease

Methylguanidine (MG), one of the most detrimental uremic toxins, is a product of creatinine oxidation. Although the amount of MG output depends on the concentration of creatinine, it is thought that the participation of active oxygen in the process of MG production markedly boosts its productivity1. In patients with end-stage renal disease (ESRD), the level of MG output may depend on the formation of active oxygen, since such patients have an increased amount of ceratinine which is a precursor of MG2–6. In fact, some patients who have more than 10 mg/dl of plasma creatinine (P-CR) respond well to conservative therapy and do not require hemodialysis treatment.