Abstracts from the XXXVIII Congress of the European Society for Artificial Organs (ESAO 2011) and IV Biennial Congress of the International Federation on Artificial Organs (IFAO 2011)

Abstract

A49 increased skin autofl uorescence and rate of increase. By not being infl uenced by single dialysis sessions, SAF shows to be a useful marker for assessing AGE accumulation and studying the related CV risk in HD patients. O1 (EI0222)Objectives: To measure annual increase in skin autofl uorescence (AF), a marker of accumulation of Advanced Glycation end products (AGEs) in the skin of hemodialysis (HD) patients and various plasma markers including heart-type fatty acid binding protein (H-FABP) in order to fi nd factors that can predict the mortality of HD patients. Materials and Methods: One hundred sixty-nine HD patients were enrolled in a clinical prospective study. Skin AF was measured at 4 time points at approximately 6 months intervals. At the same time points the routine blood chemistry and plasma markers of oxidative stress (Superoxide Dismutase and Myeloperoxydase), infl ammation (C-Reactive Protein: CRP), endothelial activation (intercellular Adhesion Molecule-1: ICAM-1 and von Willebrand Factor) and myocardial and kidney damage (H-FABP) were measured. The entire study lasted 32 months. Results: Skin AF was increased in HD patients, especially in those with diabetes, in which it showed to be the sole independent marker of the presence of cardiovascular diseases (CVD). The mean annual increase of Skin AF (ΔAF) was 0.15 ± 0.09 AU (mean ± standard error). Seasonal fl uctuations in Skin AF with a mean of 0.31 ± 0.10 AU (mean ± standard error) were only present in patients with Hepatitis C. In the multivariate Cox regression analysis we found that age diabetes, hypertension, annual ΔAF and values of CRP, ICAM-1 and H-FABP at the start of the study were independent predictors of overall mortality. Strong predictors of CVD mortality were age, diabetes, male gender, annual ΔAF and H-FABP and albumins. Moreover, combined use of annual ΔAF and single measurement H-FABP gives even better results in the prediction of the CVD mortality risk than separate use. Conclusions: Annual ΔAF and single measurement of H-FABP are strong independent predictors of overall and CVD mortality in HD patients.Objectives: Advanced glycation endproducts (AGEs) accumulate in all human subjects, e.g. in the skin. Because part of the AGEs shows autofl uorescence, skin autofl uorescence (SAF) generally increases with calendar age. SAF values above normal have been reported in patients with cardiovascular (CV) risk. SAF was a strong marker of CV mortality in hemodialysis (HD) patients [Meerwaldt, JASN 2005]. High levels of plasma AGEs were reported as well in HD patients compared to control subjects [Floridi, NDT 2002]. A consortium was formed to study the use of SAF for measuring the effectiveness of interventions that aim to decrease (CV) risk in dialysis patients. Methods: SAF was measured non-invasively with the AGE Reader (DiagnOptics Technologies B.V., Groningen, The Netherlands) at the inner forearm in HD patients: 33 (Umeå), 170 (Skopje), and 109 (Groningen). In Umeå and Skopje measurements were repeated at least twice a year for 15...