Skin Autofluorescence and the Association with Renal and Cardiovascular Risk Factors in Chronic Kidney Disease Stage 3
Open Access
- 1 October 2011
- journal article
- Published by Ovid Technologies (Wolters Kluwer Health) in Clinical Journal of the American Society of Nephrology
- Vol. 6 (10), 2356-2363
- https://doi.org/10.2215/cjn.02420311
Abstract
Background and objectives Tissue advanced glycation end products (AGE) accumulation is a measure of cumulative metabolic stress. Assessment of tissue AGE by skin autofluorescence (SAF) correlates well with cardiovascular (CV) outcomes in diabetic, transplant, and dialysis patients, and may be a useful marker of CV risk in earlier stages of chronic kidney disease (CKD). Design, setting, participants, & measurements 1707 patients with estimated GFR 59 to 30ml/min per 1.73 m2 were recruited from primary care practices for the Renal Risk In Derby (RRID) study. Detailed medical history was obtained, and each participant underwent clinical assessment as well as urine and serum biochemistry tests. SAF was assessed (mean of three readings) as a measure of skin AGE deposition using a cutaneous AF device (AGE Reader™, DiagnOptics, Groningen, The Netherlands). Results Univariate analysis revealed significant correlations between AF readings and several potential risk factors for cardiovascular disease (CVD) and progression of CKD. SAF readings (arbitrary units) were also significantly higher among males (2.8 ± 0.7 versus 2.7 ± 0.6), diabetics (3.0 ± 0.7 versus 2.7 ± 0.6), patients with evidence of self-reported CVD (2.9 ± 0.7 versus 2.7 ± 0.6), and those with no formal educational qualifications (2.8 ± 0.6 versus 2.6 ± 0.6; P < 0.01 for all). Multivariable linear regression analysis identified hemoglobin, diabetes, age, and eGFR as the most significant independent determinants of higher SAF (standardized coefficients −0.16, 0.13, 0.12, and −0.10, respectively; R2 = 0.17 for equation). Conclusion Increased SAF is independently associated with multiple CV and renal risk factors in CKD 3. Long-term follow-up will assess the value of SAF as a predictor of CV and renal risk in this population.Keywords
This publication has 45 references indexed in Scilit:
- Skin autofluorescence is increased in patients with carotid artery stenosis and peripheral artery diseaseThe International Journal of Cardiovascular Imaging, 2011
- Low-molecular-weight AGEs are associated with GFR and anemia in patients with type 2 diabetesKidney International, 2004
- Effect of carbonyl compounds on red blood cells deformabilityBiochemical and Biophysical Research Communications, 2004
- Simple non-invasive assessment of advanced glycation endproduct accumulationDiabetologia, 2004
- The Index of Multiple Deprivation 2000 and accessibility effects on healthJournal of Epidemiology and Community Health, 2004
- The Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood PressureThe JNC 7 ReportJAMA, 2003
- Aortic pulse wave velocity index and mortality in end-stage renal diseaseKidney International, 2003
- A central body fat distribution is related to renal function impairment, even in lean subjectsAmerican Journal of Kidney Diseases, 2003
- From life to death – the struggle between chemistryand biology during aging: the Maillard reaction as an amplifier of genomic damageBiogerontology, 2000
- Cardiovascular disease and mortality in a community-based cohort with mild renal insufficiencyKidney International, 1999