title: Tissue advanced glycation end products (AGEs), measured by skin autofluorescence, predict mortality in peritoneal dialysis.
abstract: OBJECTIVE
  The relation between tissue AGEs and mortality in end-stage renal disease (ESRD) is documented, but only in hemodialysis (HD) patients. This study aimed to measure and compare tissue AGEs levels in patients receiving either HD or peritoneal dialysis (PD) and to study the effect of these products on all-cause, cardiovascular or sepsis-related mortality.
  
  
  METHODS
  Tissue AGEs were noninvasively assessed in 304 dialysis patients (202 on chronic HD and 102 on continuous ambulatory PD) by measuring skin autofluorescence using a validated Autofluorescence Reader (AGE Reader, DiagnOptics b.v., Groningen, The Netherlands).
  
  
  RESULTS
  There was no difference in regard to AGEs levels between the HD (3.6 ± 0.8 AU)- and PD (3.5 ± 0.7 AU, p = 0.2)-treated patients. Diabetic patients had higher AGEs values in the HD group (3.97 ± 0.81 vs. 3.52 ± 0.77, p = 0.002), but not in the PD group (3.68 ± 0.6 vs. 3.45 ± 0.70, p = 0.26). In PD patients, increasing AGEs levels were associated with an elevated risk of all-cause mortality (a 2.09-fold increase for each increment of 1 AU in AGEs values) and sepsis (a 3.44-fold increase for each increment of 1 AU in AGEs values)-related mortality. Performing a similar analysis in diabetic patients, AGEs was associated only with sepsis-related mortality (a 3.08-fold increase for each increment of 1 AU in AGEs values).
  
  
  CONCLUSIONS
  This is the first study that demonstrates a relationship between tissue AGEs levels and sepsis-related mortality in PD-treated or diabetic ESRD patients. Future studies are necessary to evaluate the non-cardiovascular effects of tissue AGEs in ESRD patients.
authors.affiliation: Department of Nephrology, Gr. T. Popa University of Medicine and Pharmacy, Iasi, Romania, dimitrie.siriopol@yahoo.com.
authors.forename: Dimitrie
authors.initials: D
authors.lastname: Siriopol
authors.forename: Simona
authors.initials: S
authors.lastname: Hogas
authors.forename: Gabriel
authors.initials: G
authors.lastname: Veisa
authors.forename: Irina
authors.initials: I
authors.lastname: Mititiuc
authors.forename: Carmen
authors.initials: C
authors.lastname: Volovat
authors.forename: Mugurel
authors.initials: M
authors.lastname: Apetrii
authors.forename: Mihai
authors.initials: M
authors.lastname: Onofriescu
authors.forename: Irina
authors.initials: I
authors.lastname: Busila
authors.forename: Mihaela
authors.initials: M
authors.lastname: Oleniuc
authors.forename: Adrian
authors.initials: A
authors.lastname: Covic
mesh_terms: D000328:Adult; D000368:Aged; D002318:Cardiovascular Diseases / Q000401:mortality; D002423:Cause of Death; D003928:Diabetic Nephropathies / Q000378:metabolism* / Q000401:mortality; D005260:Female; D017127:Glycation End Products, Advanced / Q000032:analysis*; D006801:Humans; D007676:Kidney Failure, Chronic / Q000401:mortality* / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D061848:Optical Imaging; D010531:Peritoneal Dialysis, Continuous Ambulatory; D006435:Renal Dialysis; D018805:Sepsis / Q000401:mortality; D012867:Skin / Q000737:chemistry*
chemical_list: D017127:Glycation End Products, Advanced