As described earlier, sRAGE is largely formed by membrane shedding of the extracellular RAGE by ADAM10 and MMPs. In contrast, esRAGE is an alternatively spliced form of the extracellular receptor, which contains a 16 amino acid novel segment in the C2 domain. Multiple factors are likely to regulate sRAGE and esRAGE production and clearance, including but not limited to gender and the effects of hormones; oxidative stress; glycemic stress; genetic predilection; and renal disease. Likely, additional yet-to-be-discovered factors play contributory roles in the regulation of soluble RAGEs.