Evaluation of advanced glycation end products accumulation, using skin autofluorescence, in CKD and dialysis patients.

PURPOSE: Advanced glycation end products (AGE), biomarkers of metabolic stress, are frequently encountered in chronic kidney disease (CKD) patients with cardiovascular disease. Our aim was to evaluate tissue accumulation of AGEs in CKD patients and possible correlations with traditional and non-traditional cardiovascular risk factors.

METHODS: Skin AF was measured using AGE Reader in 310 patients: 157 haemodialysis patients (HD) (mean age 60 years, dialysis vintage 29 months, 19.1% diabetic), 102 peritoneal dialysis patients (PD) (mean age 56.3 years, dialysis vintage 16 months, 17.6% diabetic), 32 CKD patients (mean age 68 years, CKD duration 30 months, 34.4% diabetic) and 19 type 2 diabetic patients, without renal failure (mean age 59 years and median duration of diabetes 36 months).

RESULTS: HD patients have higher AGE levels compared to PD ones. Dialysis patients have the highest skin AF values compared to CKD patients (P < 0.05) and diabetic, without renal impairment, patients (P < 0.01). Skin AF levels in patients using ARBs and statins are comparable to those without treatment in dialysis group (HD + PD) but significantly different in PD sub-group and CKD patients. In dialysis patients, diabetes explains 17% of AGE values variance. In PD skin, AF correlates with CKD duration (P < 0.01) and dialysis vintage (P < 0.05). Skin AF values were significantly higher in anuric PD patients (P < 0.05). In our CKD group, we found no significant association with diabetes or GFR.

CONCLUSIONS: CKD patients have higher AGE values depending on duration (disease, RRT) and GFR (dialysis adequacy and RRF). Other important determinants were diabetes and age.