Accumulation of Advanced Glycation End Products Independently Increases the Risk of Hospitalization Among Hemodialysis Patients

Abstract

Objective: To determine the association between AGE accumulation detected by skin-autofluorescence (SAF) and hospitalization among ESKD patients.Materials and Methods: 196 ESKD patients from two hemodialysis (HD) units in Bangkok were enrolled in this retrospective study from November 2015 to March 2016. Before HD treatment, AGEs were measured with the SAF device on the area with intact skin on the volar surface of the non-fistula arm. The study concluded in December 2020, and the number of and causes of hospitalization were reviewed. A logistic regression model was used to determine the association between SAF level and patient hospitalization.Results: Of the 196 patients enrolled in the study, SAF was measured in 165 patients with a mean (SD) age of 69.2 (13.0) years. Most of the participants were non-smokers who had hypertension and diabetes and were on high-flux dialyzers. The average weekly spKt/V was 2.1, and the mean (SD) SAF was 3.05 (0.81) AU. The group with high SAF consisted of older patients and had a higher proportion of diabetics and smokers, but this was not statistically significant when compared to the low SAF group. In the multivariable analysis model, SAF greater or equal to 3.05 AU (OR = 2.28; 95% CI, 1.05–4.94; P < 0.05) and increased age (OR = 1.05; 95% CI, 1.01–1.09; P < 0.05) were associated with an increased risk of hospitalization.Conclusion: Higher values of age and SAF were independently associated with increased risk of hospitalization among ESKD patients.