title: Tissue advanced glycation end product deposition after kidney transplantation.
abstract: BACKGROUND
  Tissue advanced glycation end products (AGEs) accumulate in chronic kidney disease (CKD) and are a measure of cumulative metabolic stress. Measurement of tissue AGEs by skin autofluorescence (SAF) correlates well with cardiovascular outcomes in dialysis patients. SAF levels in transplant recipients relative to CKD and dialysis patients have not been previously studied, and the impact of transplantation on SAF levels in dialysis patients is unknown.
  
  
  METHODS
  SAF was measured using an AGE reader in 66 patients who had received a kidney transplant. Values were compared to those obtained in 1,707 patients with CKD stage 3 and in 115 patients on dialysis.
  
  
  RESULTS
  Mean SAF in transplant recipients [2.81 ± 0.64 arbitrary units (AU)] was significantly lower than in patients on haemodialysis (3.73 ± 0.88 AU) and peritoneal dialysis (3.57 ± 0.75 AU; p < 0.001), but was no different from CKD stage 3 (2.79 ± 0.66 AU; p = 0.42). In the transplant group, SAF correlated most strongly with age (r = 0.316). There was no correlation between SAF and estimated glomerular filtration rate or renal replacement therapy vintage. A small cohort of patients with SAF recorded on dialysis and following transplantation showed a drop in SAF over a mean time of 16 months after transplantation.
  
  
  CONCLUSIONS
  Tissue AGE values in kidney transplant recipients are significantly lower than in patients receiving dialysis and similar to those in patients with CKD stage 3. Our data suggest that transplantation may be associated with a reduction in tissue AGEs, and this might be an important component of the observed reduction in cardiovascular risk in transplant recipients compared to patients on dialysis.
authors.affiliation: Department of Renal Medicine, Royal Derby Hospital, Derby, UK.
authors.forename: Lisa E
authors.initials: LE
authors.lastname: Crowley
authors.forename: Catherine P
authors.initials: CP
authors.lastname: Johnson
authors.forename: Natasha
authors.initials: N
authors.lastname: McIntyre
authors.forename: Richard J
authors.initials: RJ
authors.lastname: Fluck
authors.forename: Christopher W
authors.initials: CW
authors.lastname: McIntyre
authors.forename: Maarten W
authors.initials: MW
authors.lastname: Taal
authors.forename: Janson C H
authors.initials: JC
authors.lastname: Leung
mesh_terms: D022561:Advanced Cardiac Life Support / Q000379:methods*; D000368:Aged; D005260:Female; D017127:Glycation End Products, Advanced / Q000378:metabolism*; D006801:Humans; D016030:Kidney Transplantation / Q000706:statistics & numerical data*; D008297:Male; D008875:Middle Aged; D006435:Renal Dialysis / Q000706:statistics & numerical data*; D051436:Renal Insufficiency, Chronic / Q000378:metabolism* / Q000628:therapy*; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D012867:Skin / Q000378:metabolism*
chemical_list: D017127:Glycation End Products, Advanced