Association of Skin Autofluorescence Levels With Kidney Function Decline in Patients With Peripheral Artery Disease

Abstract

Objective— Skin autofluorescence (SAF), a measure of advanced glycation end product accumulation, is associated with kidney function. We investigated the association of SAF with rate of kidney function decline in a cohort of patients with peripheral artery disease. Approach and Results— We performed a post hoc analysis of an observational longitudinal cohort study. We included 471 patients with peripheral artery disease, and SAF was measured at baseline. Primary end point was rate of estimated glomerular filtration rate (eGFR) decline. Secondary end points were incidence of eGFR <60 and <45 mL/min/1.73 m 2 and rapid eGFR decline, defined as a decrease in eGFR of >5 mL/min/1.73 m 2 /y. During a median follow-up of 3 years, the mean change in eGFR per year was −1.8±4.4 mL/min/1.73 m 2 /y. No significant difference in rate of eGFR decline was observed per 1 arbitrary unit increase in SAF (−0.1 mL/min/1.73 m 2 /y; 95% confidence interval, −0.7 to 0.5; P =0.8). Analyses of the secondary end points showed that there was an association of SAF with incidence of eGFR <60 and <45 mL/min/1.73 m 2 (hazard ratio, 1.54; 95% confidence interval, 1.13–2.10; P =0.006 and hazard ratio, 1.76; 95% confidence interval, 1.20–2.59; P =0.004, respectively), but after adjustment for age and sex, significance was lost. There was no association of SAF with rapid eGFR decline. Conclusions— In conclusion, in this cohort of patients with peripheral artery disease, elevated SAF was associated with lower baseline eGFR. Although SAF has previously been established as a predictor for cardiovascular disease and mortality, it did not predict the rate of kidney function decline during follow-up in this study.

Recent Advances and the Potential for Clinical Use of Autofluorescence Detection of Extra-Ophthalmic Tissues

“…Crowley et al showed significantly lower SAF values in kidney transplant recipients (2.81 ± 0.64 AU), compared to patients on hemodialysis (3.73 ± 0.88 AU) or peritoneal dialysis (3.57 ± 0.75 AU), respectively [69]. Whether kidney function can be predicted by SAF was investigated by Schutte et al in 471 patients with peripheral artery disease and preserved kidney function [70]. An increase in SAF during the three-year follow-up period was not associated with kidney function decline (assessed by the estimated glomerular filtration rate).…”

Correlation Between Skin Autofluorescence and Muscle Activities of Lower Limb in Aging Without Disease and Disability

“…Skin autofluorescence (AF) is one of the markers to evaluate the accumulation of AGEs in human tissues ( Meerwaldt et al, 2004 , 2005 ). Over the past few years a considerable number of studies have been made on the relationship between skin AF and various diseases, for example, type 1 or type 2 diabetes ( Fokkens & Smit, 2016 ; Osawa et al, 2017 ; Temma et al, 2015 ), cardiovascular disease ( Yamagishi et al, 2015 ), chronic kidney disease ( Furuya et al, 2015 ), peripheral artery disease ( de Vos et al, 2014 ; Schutte et al, 2016 ), and chronic obstructive pulmonary disease ( Gopal et al, 2014 ; Hoonhorst et al, 2014 ). These pathological studies have shown that skin AF is a useful index to estimate these diseases as a simple and non-invasive method.…”