Key result
Mild-to-moderate CKD is linked to a ~14% increase in skin autofluorescence versus matched controls.
Why the study?
Little information exists about the relationship between advanced glycation end-products and subclinical atherosclerosis at the early stages of chronic kidney disease.
Is skin autofluorescence associated with subclinical atherosclerosis in patients with mild-to-moderate CKD?
Case-Control (n=174)
No
Is skin autofluorescence associated with subclinical atherosclerosis in patients with mild-to-moderate CKD?
Absolute Event Rate: 2.5% vs 2.2%
p-value: p=<0.001
Skin autofluorescence is elevated in mild-to-moderate CKD and is independently associated with subclinical atheromatous disease, suggesting its utility in early cardiovascular risk assessment.
May aid early CV risk assessment in mild-to-moderate CKD; hypothesis-generating for subclinical atherosclerosis utility in observational data.
Advanced glycation end-products (AGEs) are increased and predict mortality in patients with chronic kidney disease (CKD) who are undergoing hemodialysis, irrespective of the presence of type 2 diabetes. However, little information exits about the relationship between AGEs and subclinical atherosclerosis at the early stages of CKD. A case-control study was performed including 87 patients with mild-to-moderate stages of CKD (glomerular filtration rate from 89 to 30 ml/min/per 1.73m2) and 87 non-diabetic non-CKD subjects matched by age, gender, body mass index, and waist circumference. Skin autofluorescence (AF), a non-invasive assessment of AGEs, was measured. The presence of atheromatous disease in carotid and femoral arteries was evaluated using vascular ultrasound, and vascular age and SCORE risk were estimated. Patients with mild-to-moderate stages of CKD showed an increase in skin AF compared with control subjects (2.5±0.6 vs. 2.2±0.4 AU, p<0.001). A skin AF value >2.0 AU was accompanied by a 3-fold increased risk of detecting the presence of an atheromathous plaque (OR 3.0, 95% CI 1.4-6.5, p = 0.006). When vascular age was assessed through skin AF, subjects with CKD were almost 12 years older than control subjects (70.3±25.5 vs. 58.5±20.2 years, p = 0.001). Skin AF was negatively correlated with glomerular filtration rate (r = -0.354, p<0.001) and LDL-cholesterol (r = -0.269, p = 0.001), and positively correlated with age (r = 0.472, p<0.001), pulse pressure (r = 0.238, p = 0.002), and SCORE risk (r = 0.451, p<0.001). A stepwise multivariate regression analysis showed that age and glomerular filtration rate independently predicted skin AF (R2 = 0.289, p<0.001). Skin AF is elevated in patients with mild-to-moderate CKD compared with control subjects. This finding may be independently associated with the glomerular filtration rate and the presence of subclinical atheromatous disease. Therefore, the use of skin AF may help to accurately evaluate the real cardiovascular risk at the early stages of CKD.
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Sánchez et al. (2017) conducted a case-control in Mild to moderate Chronic Kidney Disease (n=174). Mild to moderate Chronic Kidney Disease vs. Non-CKD subjects was evaluated on Skin autofluorescence (AU) (p=<0.001). Mild-to-moderate chronic kidney disease was associated with significantly increased skin autofluorescence compared to matched controls (2.5 vs 2.2 AU, p<0.001).
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