Skin autofluorescence is associated with renal function and cardiovascular diseases in pre-dialysis chronic kidney disease patients

Tanaka, Kenichi; Tani, Yasuhiro; Asai, Jun; Nemoto, Fumihiko; Kusano, Yuki; Suzuki, Hodaka; Hayashi, Yoshimitsu; Asahi, Koichi; Katoh, Tetsuo; Miyata, Toshio; Watanabe, Tsuyoshi

doi:10.1093/ndt/gfq369

Cited by 43 publications

(46 citation statements)

References 31 publications

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“…Our observations confirm previous observations in a relatively small cohort of hospital-based Japanese patients that chronological age, diabetes, eGFR, and past history of CVE are independent determinants of SAF in participants with CKD stage 3 (29). In addition, we found that hemoglobin (negative association), past history of smoking, proteinuria, and social deprivation were also determinants of SAF in CKD stage 3.…”

Section: Discussionsupporting

confidence: 91%

“…Diabetes has been shown to be an independent determinant of higher SAF values in participants with and without CKD (3,22,29). We observed significantly higher SAF readings in those with diabetes compared with those without (Table 4), and confirmed diabetes as an important independent determinant of SAF in the multivariable analysis ( Table 5).…”

Section: Diabetes As a Determinant Of Higher Safsupporting

confidence: 75%

“…Nevertheless, much of the previous work was performed with participants who were already on renal replacement therapy or had developed macrovascular complications of diabetes. However, Tanaka et al (29) found, in their cohort of predialysis participants, that eGFR emerged as one of the strongest predictors of SAF and that SAF increased as CKD stage advanced. Even although all participants in our cohort had CKD stage 3, comparison of CKD stage 3A (eGFR ϭ 45 to 59 ml/min per 1.73 m 2 ) with CKD stage 3B (eGFR ϭ 30 to 44 ml/min per 1.73 m 2 ) showed significantly higher SAF in those with CKD stage 3B (3A ϭ 2.7 AU versus 3B ϭ 3.0 AU; P Ͻ 0.0001), and eGFR remained an independent determinant of SAF in the multivariable analysis.…”

Section: Egfr and Proteinuria As A Determinant Of Higher Safmentioning

confidence: 92%

“…One previous study (29) reported a univariate correlation between hemoglobin and SAF, but hemoglobin did not enter the equation in the multivariable analysis. Hemoglobin was, however, an independent determinant of SAF in a subgroup of participants with diabetes in that study.…”

Section: Hemoglobin As a Determinant Of Higher Safmentioning

confidence: 99%

“…One recent systematic review has identified seven studies that all reported positive associations between SAF readings and complications of diabetes (excluding retinopathy) (26). Although the relationship between SAF, renal function, and CVD has been reported in patients with more advanced CKD (both in dialysis and transplant patients) (3,27,28), and, more recently, in a hospital-based study of 304 predialysis patients (29), it has not previously been described in a community-based population of patients with mild to moderately reduced kidney function. In this cross-sectional analysis, we aimed to identify associations between SAF and renal, as well as cardiovascular, risk factors in a community-based cohort of patients with CKD stage 3.…”

Section: Introductionmentioning

confidence: 99%

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Skin Autofluorescence and the Association with Renal and Cardiovascular Risk Factors in Chronic Kidney Disease Stage 3

McIntyre¹,

Fluck²,

McIntyre³

et al. 2011

Clinical Journal of the American Society of Nephrology

103

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SummaryBackground 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 m 2 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 Ϯ 0.7 versus 2.7 Ϯ 0.6), diabetics (3.0 Ϯ 0.7 versus 2.7 Ϯ 0.6), patients with evidence of self-reported CVD (2.9 Ϯ 0.7 versus 2.7 Ϯ 0.6), and those with no formal educational qualifications (2.8 Ϯ 0.6 versus 2.6 Ϯ 0.6; P Ͻ 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 Ϫ0.16, 0.13, 0.12, and Ϫ0.10, respectively; R 2 ϭ 0.17 for equation). ConclusionIncreased 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.

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Section: Discussionsupporting

confidence: 91%

Section: Diabetes As a Determinant Of Higher Safsupporting

confidence: 75%

Section: Egfr and Proteinuria As A Determinant Of Higher Safmentioning

confidence: 92%

Section: Hemoglobin As a Determinant Of Higher Safmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Skin Autofluorescence and the Association with Renal and Cardiovascular Risk Factors in Chronic Kidney Disease Stage 3

McIntyre¹,

Fluck²,

McIntyre³

et al. 2011

Clinical Journal of the American Society of Nephrology

103

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Advanced glycation end‐products (AGEs) and associations with cardio‐metabolic, lifestyle, and dietary factors in a general population: the NQplus study

Botros

Sluik

Waateringe

et al. 2017

Diabetes Metabolism Res

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Skin autofluorescence as a marker of cardiovascular risk in children with chronic kidney disease

et al. 2012

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BackgroundWe examined skin autofluorescence (sAF) in chronic kidney disease children (CKD) in relation to renal function and dialysis modality.MethodsTwenty children on hemodialysis (HD), 20 on peritoneal dialysis (PD), 36 treated conservatively, and 26 healthy subjects were enrolled into the study. In all children sAF, pulse-wave velocity indexed to height (PWV/ht), left ventricular mass index (LVMI), blood pressure (BP), serum lipid profile, phosphate (P), calcium (Ca), and homocysteine were measured.ResultssAF was significantly elevated in CKD groups vs. controls and was significantly associated with PWV/ht, LVMI, BP, P, Ca × P product and homocysteine. sAF in HD and PD groups was positively correlated with dialysis vintage, and in the predialysis group negatively correlated with glomerular filtration rate (eGFR). Multiple regression analysis showed significant association of sAF with LVMI and P in the CKD patient group, and with dialysis treatment duration and BP in dialyzed children.ConclusionsIn CKD children, tissue accumulation of advanced glycation end-products (AGEs) was observed. This was aggravated as eGFR declined and was related to early cardiovascular changes and some biochemical cardiovascular disease (CVD) risk markers. sAF as a non-invasive method may be a useful tool for identification of a clinical risk factors of cardiovascular disease in CKD children.

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Skin autofluorescence is associated with renal function and cardiovascular diseases in pre-dialysis chronic kidney disease patients

Abstract: Tissue AGE accumulation measured as skin autofluorescence increased as GFR decreased and was related to CVD history in CKD patients. Non-invasive autofluorescence readers may provide potential markers for clinical risk assessment in pre-dialysis CKD patients.

Cited by 43 publications

References 31 publications

Skin Autofluorescence and the Association with Renal and Cardiovascular Risk Factors in Chronic Kidney Disease Stage 3

Skin Autofluorescence and the Association with Renal and Cardiovascular Risk Factors in Chronic Kidney Disease Stage 3

Advanced glycation end‐products (AGEs) and associations with cardio‐metabolic, lifestyle, and dietary factors in a general population: the NQplus study

Skin autofluorescence as a marker of cardiovascular risk in children with chronic kidney disease

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