Abstract
Chronic kidney disease (CKD) is associated with high morbidity and mortality rates, main causes related with cardiovascular disease (CVD) and bone mineral disorder (CKD-BMD). Uremic toxins, as advanced glycation end products (AGEs), are non-traditional cardiovascular risk factor and play a role on development of CKD-BMD in CKD. The measurement of skin autofluorescence (sAF) is a noninvasive method to assess the level of AGEs in tissue, validated in CKD patients. The aim of this study is analyze AGEs measured by sAF levels (AGEs-sAF) and its relations with CVD and BMD parameters in HD patients. Twenty prevalent HD patients (HD group) and healthy subjects (Control group, n = 24), performed biochemical tests and measurements of anthropometric parameters and AGEs-sAF. In addition, HD group performed measurement of intact parathormone (iPTH), transthoracic echocardiogram and radiographies of pelvis and hands for vascular calcification score. AGEs-sAF levels are elevated both in HD and control subjects ranged according to the age, although higher at HD than control group. Single high-flux HD session does not affect AGEs-sAF levels. AGEs-sAF levels were not related to ventricular mass, interventricular septum or vascular calcification in HD group. AGEs-sAF levels were negatively associated with serum iPTH levels. Our study detected a negative correlation of AGEs-sAF with serum iPTH, suggesting a role of AGEs on the pathophysiology of bone disease in HD prevalent patients. The nature of this relation and the clinical application of this non-invasive methodology for evaluation AGEs deposition must be confirmed and clarified in future studies.
Highlights
Chronic kidney disease (CKD) is associated with high morbidity and mortality rates, main causes related with cardiovascular disease (CVD) and bone mineral disorder (CKD-BMD)
advanced glycation end products (AGEs)-skin autofluorescence (sAF) levels ranged according age are elevated both in HD and control groups, it was significantly higher in HD group
AGEs-sAF was negatively associated with serum intact parathormone (iPTH) levels, the main bone turnover marker used in CKD-MBD management
Summary
Chronic kidney disease (CKD) is associated with high morbidity and mortality rates, main causes related with cardiovascular disease (CVD) and bone mineral disorder (CKD-BMD). Advanced glycation end-products (AGEs) are uremic toxins which are elevated in CKD because of increased production by oxidative stress, impaired renal excretion and diet consumption.[3] The measurement of skin autofluorescence (sAF) is a noninvasive method used to indirectly evaluate the accumulation of AGEs in this tissue. This methodology was validated in studies, including those with CKD patients, through the comparison between AGEs-sAF values and density of AGEs in skin biopsies processed by immunohistochemistry for AGEs.[3,4,5]
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