Advanced Glycation Endproducts, Blood Pressure, and Arterial Stiffness in Chronic Kidney Disease Patients—are They Related?

Objective: Advanced glycation end-products (AGEs) are proteins that become glycated after contact with sugars and are implicated in endothelial dysfunction and arterial stiffening (AS). We aimed to investigate the relationships between AGE, measured as skin autofluorescence (SAF), blood pressure (BP) and vascular stiffness in subjects with chronic kidney disease (CKD). Design and method: This cross-sectional study conducted at the Nephrology Outpatient Clinic at UHC Split included 117 CKD participants. For each participant, AGE SAF measurement using AGE Reader MU was made; data on eGFR was collected. The Agedio B 900 device was used to assess central and peripheral BP and arterial stiffness. Data on pulse wave velocity (PWV) (m/s), peripheral systolic BP (pSBP), diastolic BP (pDBP), pulse pressure (pPP), central systolic BP (cSBP), diastolic BP (cDBP), and pulse pressure (pcPP) were obtained. Results: The study included 117 participants aged 69 (56 - 75) years, 81(68.1%) males with CKD and average AGE levels were 2.7 (2.3 – 3.3). Furthermore, we classified participants into four categories based on their AGE values: 30 (25.2%) did not have CV risk, 37 (31.1%) had lightly increased CV risk while 7 (5.9%) had increased CV risk. Statistically significant difference in PWV was found between four categories of CV risk (p < 0.001). Also, significant positive correlation between AGE, pPP (r = 0.204, p=0.03) and PWV (r = 0.357, p< 0.001) was found, while significant negative correlation between AGE and PDBP was found (r =-0.210, p=0.03). Significant negative correlation between eGFR and AGE level was found (r =-0.409, p<0.001). Participants with eGFR < 60 had significantly higher value of cPP (p=0.04), PWV(p=0.04) and AGE level (p< 0.001) and they were significantly older (p< 0.001). Conclusions: Our findings indicate that AGEs measured as SAF might be involved in vascular stiffening and blood pressure in individuals with CKD. SAF might prove as a rapid and non-invasive method for assessment of CV risk in this very high-risk population of patients.