title: Skin autofluorescence and the association with renal and cardiovascular risk factors in chronic kidney disease stage 3.
abstract: OBJECTIVE
  Tissue advanced glycation end products (AGE) accumulation is a measure of cumulative metabolic stress. Assessment of tissue AGE by skin autofluorescence (SAF) correlates well with cardiovascular (CV) outcomes in diabetic, transplant, and dialysis patients, and may be a useful marker of CV risk in earlier stages of chronic kidney disease (CKD).
  
  
  METHODS
  1707 patients with estimated GFR 59 to 30 ml/min per 1.73 m(2) were recruited from primary care practices for the Renal Risk In Derby (RRID) study. Detailed medical history was obtained, and each participant underwent clinical assessment as well as urine and serum biochemistry tests. SAF was assessed (mean of three readings) as a measure of skin AGE deposition using a cutaneous AF device (AGE Reader™, DiagnOptics, Groningen, The Netherlands).
  
  
  RESULTS
  Univariate analysis revealed significant correlations between AF readings and several potential risk factors for cardiovascular disease (CVD) and progression of CKD. SAF readings (arbitrary units) were also significantly higher among males (2.8 ± 0.7 versus 2.7 ± 0.6), diabetics (3.0 ± 0.7 versus 2.7 ± 0.6), patients with evidence of self-reported CVD (2.9 ± 0.7 versus 2.7 ± 0.6), and those with no formal educational qualifications (2.8 ± 0.6 versus 2.6 ± 0.6; P < 0.01 for all). Multivariable linear regression analysis identified hemoglobin, diabetes, age, and eGFR as the most significant independent determinants of higher SAF (standardized coefficients -0.16, 0.13, 0.12, and -0.10, respectively; R(2) = 0.17 for equation).
  
  
  CONCLUSIONS
  Increased SAF is independently associated with multiple CV and renal risk factors in CKD 3. Long-term follow-up will assess the value of SAF as a predictor of CV and renal risk in this population.
authors: Department of Renal Medicine, Royal Derby Hospital, Uttoxeter Road, Derby, Derbyshire, United Kingdom DE22 3NE.
authors: Natasha J
authors: NJ
authors: McIntyre
authors: Richard J
authors: RJ
authors: Fluck
authors: Christopher W
authors: CW
authors: McIntyre
authors: Maarten W
authors: MW
authors: Taal
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D015415:Biomarkers / Q000032:analysis; D002318:Cardiovascular Diseases / Q000209:etiology* / Q000378:metabolism; D002908:Chronic Disease; D018450:Disease Progression; D004739:England; D005260:Female; D005453:Fluorescence; D005542:Forearm; D005919:Glomerular Filtration Rate; D017127:Glycation End Products, Advanced / Q000032:analysis*; D006801:Humans; D007674:Kidney Diseases / Q000150:complications / Q000175:diagnosis / Q000378:metabolism* / Q000503:physiopathology; D016014:Linear Models; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D011446:Prospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D012867:Skin / Q000737:chemistry*; D015854:Up-Regulation
chemical_list: D015415:Biomarkers; D017127:Glycation End Products, Advanced