Skin Autofluorescence Is Associated with the Progression of Chronic Kidney Disease: A Prospective Observational Study

Tanaka, Kenichi; Nakayama, Masaaki; Kanno, Makoto; Kimura, Hiroshi; Watanabe, Kimio; Tani, Yasuhiro; Kusano, Yuki; Suzuki, Hodaka; Hayashi, Yoshimitsu; Asahi, Koichi; Sato, Keiji; Miyata, Toshio; Watanabe, Tsuyoshi

doi:10.1371/journal.pone.0083799

Cited by 46 publications

(33 citation statements)

References 35 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…That study showed, in a cohort of 449 Japanese predialysis CKD patients with a 32% DM prevalence, that SAF predicted the rate of kidney function decline and incidence of end-stage kidney disease. 11 The discrepant findings in our study versus those in the study by Tanaka et al 22 may be because of population differences between the cohorts. For whites, the reference value of SAF in healthy individuals is 2.46±0.57 for the age group of 60 to 70 years, and SAF has been shown to increase with ≈0.023 AU per year.…”

Section: Discussioncontrasting

confidence: 89%

“…We found no association of SAF with eGFR decline in patients with PAD, which conflicts with earlier findings that showed a significant association of SAF with eGFR decline in patients with established CKD. 11 Therefore, the use of SAF as a predictor of kidney function decline may be limited to patients without cardiovascular comorbidity or SAF may only be a predictor in patients with established CKD. Further research is needed to clarify if, and in which populations, SAF can predict kidney function decline.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

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

Schutte

Vos

Lutgers

et al. 2016

ATVB

View full text Add to dashboard Cite

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.

show abstract

Section: Discussioncontrasting

confidence: 89%

Section: Discussionmentioning

confidence: 99%

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

Schutte

Vos

Lutgers

et al. 2016

ATVB

View full text Add to dashboard Cite

show abstract

“…9 The predictive value of SAF for all-cause or cardiovascular mortality and cardiovascular events was previously shown in patients with PAD, diabetes mellitus, renal insufficiency, and myocardial infarction and for disease progression in chronic kidney disease. 10,[13][14][15][16] This study is the first to show that SAF is an independent predictor for leg outcome in patients with PAD. These results underscore the role of AGEs as predictor for progression of atherosclerosis beyond diabetes mellitus and renal insufficiency.…”

mentioning

confidence: 66%

Skin Autofluorescence as a Measure of Advanced Glycation End Products Deposition Predicts 5-Year Amputation in Patients With Peripheral Artery Disease

Vos

Boersema

Mulder

et al. 2015

ATVB

View full text Add to dashboard Cite

Objective-Patients with peripheral artery disease are at risk for critical limb ischemia and amputation. Accumulation of advanced glycation end products is increased and predictive for coronary and cerebrovascular events in several high cardiovascular risk groups. We hypothesized that accumulation of tissue advanced glycation end products, measured by skin autofluorescence (SAF), predicts amputation in patients with peripheral artery disease. Approach and Results-Between Materials and MethodsMaterials and Methods are available in the online-only Data Supplement.In short, we performed a single-center prospective cohort study of 252 patients with established PAD. Deposition of tissue AGEs was noninvasively measured by skin autofluorescence with the AGE Reader. Five-year follow-up data were analyzed. The end point was defined as amputation caused by critical limb ischemia. Amputationfree survival was analyzed by Kaplan-Meier plot with log-rank test, according to the optimal cutoff value of SAF (generated by the receiver operating characteristics curve) and to subdivision into 4 groups, based on Fontaine stage (I-II versus III-IV) and SAF below or above the cutoff value. Subproportional hazard ratios (sHR) for amputation risk with 95% confidence interval (CI) were calculated by competing risks regression analysis, with death as the competing risk. Additional log-rank and competing risks regression analyses were performed in patients with Fontaine stage I and II. Receiver operating characteristics analysis was performed, with Fontaine stage and Fontaine stage multiplied by SAF. The study was approved by the local institutional review board, and all participating patients gave informed consent. Results Patients Characteristics and SAFA total of 267 patients were willing to participate. Fifteen patients were excluded because of hemodialysis (n=4), kidney transplantation (n=8), a recent myocardial infarction (n=1), and a recent stroke (n=2). Baseline characteristics of the 252 patients with PAD (mean age, 66±11 years) are shown in Table 1. In 38 (15%) patients, ankle-brachial index was not measured because PAD had already been established by imaging of the lower arteries (n=12) or a revascularization procedure (n=26) was performed directly. Sixty-six (26%) patients were classified as Fontaine stage I, 149 (59%) as Fontaine stage II, 21 (8%) as Fontaine stage III, and 16 (7%) patients as Fontaine stage IV. Mean anklebrachial index was 0.57±0.15. At baseline, 152 (60%) patients had an intervention for their PAD, including 21 (8%) amputations because of critical limb ischemia. Of the patients with current Fontaine stage I or II, 127 (59%) patients had a history of intervention whereas 88 (41%) had not. Of the patients with current Fontaine stage III and IV, 25 (68%) had a history intervention whereas 12 (32%) had not. Seventy-four (29%) patients had diabetes mellitus. Mean SAF was 2.76±0.66 arbitary units. Five-Year Follow-UpMedian follow-up duration was 5.3 (interquartile range, 4.7-5.7) years. Of the 252 patients who ...

show abstract

“…AGEs serum levels have been associated to several vascular and neurological complications, especially in the cardiovascular field and a flourishing production of literature is pointing at AGEs as a marker of negative outcome in both diabetes management and surgical procedures on these patients (3,4). Detection and measurement techniques for AGEs have been gradually improved over the past 10 years starting from antibody and immune-based methods to the new readily available skin auto fluorescence techniques, which hold a promise for future bedside management of patients with diabetes (5). The reported role of AGEs in vascular complications of diabetes and cardiovascu-lar disease also prompted the development of pharmacological inhibitors of their effects, giving rise to many experimental activities and a number of both preclinical and clinical studies.…”

Section: Contextmentioning

confidence: 99%

Pharmacologic approaches against Advanced Glycation End Products (AGEs) in diabetic cardiovascular disease

et al. 2015

View full text Add to dashboard Cite

Context: Advanced Glycation End-Products (AGEs) are signaling proteins associated to several vascular and neurological complications in diabetic and non-diabetic patients. AGEs proved to be a marker of negative outcome in both diabetes management and surgical procedures in these patients. The reported role of AGEs prompted the development of pharmacological inhibitors of their effects, giving rise to a number of both preclinical and clinical studies. Clinical trials with anti-AGEs drugs have been gradually developed and this review aimed to summarize most relevant reports. Evidence Acquisition: Evidence acquisition process was performed using PubMed and ClinicalTrials.gov with manually checked articles. Results: Pharmacological approaches in humans include aminoguanidine, pyridoxamine, benfotiamine, angiotensin converting enzyme inhibitors, angiotensin receptor blockers, statin, ALT-711 (alagebrium) and thiazolidinediones. The most recent promising antiAGEs agents are statins, alagebrium and thiazolidinediones. The role of AGEs in disease and new compounds interfering with their effects are currently under investigation in preclinical settings and these newer anti-AGEs drugs would undergo clinical evaluation in the next years. Compounds with anti-AGEs activity but still not available for clinical scenarios are ALT-946, OPB-9195, tenilsetam, LR-90, TM2002, sRAGE and PEDF. Conclusions: Despite most studies confirm the efficacy of these pharmacological approaches, other reports produced conflicting evidences; in almost any case, these drugs were well tolerated. At present, AGEs measurement has still not taken a precise role in clinical practice, but its relevance as a marker of disease has been widely shown; therefore, it is important for clinicians to understand the value of new cardiovascular risk factors. Findings from the current and future clinical trials may help in determining the role of AGEs and the benefits of anti-AGEs treatment in cardiovascular disease.

show abstract

Skin Autofluorescence Is Associated with the Progression of Chronic Kidney Disease: A Prospective Observational Study

Cited by 46 publications

References 35 publications

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

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

Skin Autofluorescence as a Measure of Advanced Glycation End Products Deposition Predicts 5-Year Amputation in Patients With Peripheral Artery Disease

Pharmacologic approaches against Advanced Glycation End Products (AGEs) in diabetic cardiovascular disease

Contact Info

Product

Resources

About