Comparison of skin autofluorescence, a marker of tissue advanced glycation end‐products in the fistula and non‐fistula arms of patients treated by hemodialysis

Tangwonglert, Theerasak; Vareesangthip, Kornchanok; Vongsanim, Surachet; Davenport, Andrew

doi:10.1111/aor.13741

Cited by 4 publications

(5 citation statements)

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“…In almost all studies, the arm that was used to check on SAF levels and the skin color of subjects were not reported. Only two studies demonstrated that the SAF was lower in the arteriovenous fistula arm 51 . It is unclear whether this reflects a difference in the blood supply.…”

Section: Methodsmentioning

confidence: 99%

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Role of skin autofluorescence in managing renal and cardiac diseases in outpatient dermatology

Etaee

Naguib

Goldust

et al. 2022

Skin Research and Technology

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Introduction:The accumulation of tissue-advanced glycation end products in skin results from complex and consecutive reactions and can be measured by skin autofluorescence (SAF) reader devices. This overview discusses studies evaluating the utilization of SAF in screening renal and cardiac disease. Materials and methods:Literature search was performed using Google Scholar, PubMed, Springer, Ovid, and ScienceDirect.Results: SAF was an independent predictor of progression of chronic kidney disease (CKD) and was elevated in subjects on hemodialysis and peritoneal dialysis. Furthermore, SAF was significantly associated with cardiovascular events, cardiovascular mortality, and all-cause mortality in CKD patients. Other studies revealed a correlation between SAF and arterial stiffness, vascular damage, and subclinical atherosclerosis.A vegetarian diet was associated with lower SAF levels, whereas malnutrition was correlated with higher levels and increased mortality.Conclusions: SAF measurement may be useful in managing renal and cardiac disease.Future studies are needed to clarify the specific role of SAF in the management of CKD and its noninvasive office utilization to identify comorbidities in inflammatory diseases, such as psoriasis.

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Section: Methodsmentioning

confidence: 99%

“…Only two studies demonstrated that the SAF was lower in the arteriovenous fistula arm. 51 It is unclear whether this reflects a difference in the blood supply. The value of measuring SAF in subjects with highly pigmented skin is also unclear.…”

Section: Methodsmentioning

confidence: 99%

Role of skin autofluorescence in managing renal and cardiac diseases in outpatient dermatology

Etaee

Naguib

Goldust

et al. 2022

Skin Research and Technology

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“…After each measurement the arm was repositioned to within 1 cm of the original placement. In brief, the AGE reader illuminates approximately 4 cm 2 of the skin surface with an emission ultraviolet fluorescence light wave-length between 420 and 600 nm, which causes excitation of AGEs deposited in subcutaneous tissues, and then measures the autofluorescence-reflected light from the skin, wave length of 300-420 nm with a spectrometer [17,18]. The AGE reader has a guard to prevent external light contamination [17,18].…”

Section: Methodsmentioning

confidence: 99%

“…In brief, the AGE reader illuminates approximately 4 cm 2 of the skin surface with an emission ultraviolet fluorescence light wave-length between 420 and 600 nm, which causes excitation of AGEs deposited in subcutaneous tissues, and then measures the autofluorescence-reflected light from the skin, wave length of 300-420 nm with a spectrometer [17,18]. The AGE reader has a guard to prevent external light contamination [17,18]. The AGE reader was fitted with an additional light source for those with darker skin pigmentation, and measurements were adjusted for skin colour by proprietary software (DiagnOptics, Groningen, Netherlands).…”

Section: Methodsmentioning

confidence: 99%

Is the measurement of tissue advanced glycosylation products by skin autofluorescence associated with mortality in patients treated by peritoneal dialysis?

2022

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Background Advanced glycosylated end-products (AGEs) have been shown to cause cardiovascular disease, and tissue AGE accumulation can be measured by skin autofluorescence (SAF). AGEs are cleared by the kidney, and thus accumulate in dialysis patients. However, as the results of SAF measurements in peritoneal dialysis patients (PD) have been ambiguous, we examined the association between mortality and SAF. Methods We reviewed SAF measurements in PD patients attending a university associated PD program, along with standard measurements of dialysis adequacy and peritoneal membrane function. Results We studied 341 prevalent PD patients, 61.9% male, mean age 61.2 ± 16 years, and 31.4% of all patients died during a median follow-up of 27.2 (23.3–36.3) months. Patients who died were older, mean age 72 ± 10.5 years, were more often diabetic (60.7%), and had higher median SAF 3.8 (3.2–4.5) AU. On logistic regression, mortality was independently associated with age (odds ratio (OR) 1.1 (95% confidence limits 1.06–1.16), diabetes OR 10.1 (3.1–33.4), SAF OR 3.3 (1.8–6.2), all p < 0.001, and male gender OR 5.2 (1.6–17.4), p = 0.007; and negatively associated with weight OR 0.91 (0.86–0.95), p < 0..001, normalised nitrogen appearance rate (nPNA) OR 0.05 (0.01–0.4), p = 0.005 and mean arterial blood pressure (MAP) OR 0.96 (0.93–0.96), p = 0.03. Conclusions In this observational study, SAF was independently associated with mortality. However, other factors were also associated with mortality, including age, diabetes and malnutrition which have all been reported to affect SAF measurements. Thus, the additional predictive value of measuring SAF compared to standard risk factors for mortality remains to be determined. Graphical abstract

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“…Com isso, fatores pró-inflamatórios e seus receptores, incluindo AGEs e RAGE passam a ser expressos e acumulados em maior quantidade, resultando no aumento de AGEs-Os níveis de AGEs-sAF em pacientes submetidos a HD variam entre os estudos, possivelmente devido aos critérios de inclusão, as características das diálises utilizadas, como por exemplo, hemodiafiltração ou HD convencional, o tempo em diálise e até mesmo o tipo de acesso venoso utilizado. [140][141][142][143] Já no caso da DP, J. Jing et al, evidenciou que a carga de glicose utilizada no banho parece contribuir para o aumento de AGEs no organismo, entretanto, apesar de não termos quantificado a carga glicêmica prescrita, podemos observar pacientes submetidos a DP são mais sujeitos a acúmulo de AGEs-sAF, evidenciado após modelo de regressão linear não ajustado e ajustado 143.…”

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Estudo de validação do aparelho AGE-Reader em amostra da população brasileira sem e com doença renal crônica

Yuri Sano

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Ao professor Rodrigo Bueno de Oliveira que sempre me ajudou de forma incansável com seus conhecimentos e conselhos. Sempre muito dedicado ao trabalho e a ciência.A todos da equipe "LEMON": Célia, Kélcia, Noemi, Cinthia, Lais e Lígia. Todas dedicadas ao desenvolvimento do laboratório e às pesquisas ali realizadas.A Valéria, amiga antiga, que desde os tempos de Itajubá me ajuda com seus conhecimentos em pesquisa. RESUMOINTRODUÇÃO: Os produtos avançados da glicação não enzimática (AGEs) estão envolvidos na fisiopatologia de doenças cardiovasculares e na doença renal crônica (DRC), e podem ser aferidos de forma não invasiva pela autofluorescência da pele (AGEs-sAF) com o dispositivo AGE-Reader TM . Evidências sugerem seu emprego como biomarcador. OBJETIVOS: Estabelecer e validar uma curva populacional de distribuição de AGEs-sAF em uma amostra de brasileiros com e sem DRC. MATERIAIS E MÉTODOS: estudo clínico observacional, transversal, em indivíduos sem DRC (Controle; N=736) e com DRC (N=151: estágios 3-5 (N=19); hemodiálise (N=101) e diálise peritoneal (N=31). Foram realizadas aferições de AGES-sAF (AGEReader™), coleta de dados clínicos, laboratoriais e biópsia de pele para imunohistoquímica. Os critérios de inclusão foram: (Controle) idade >18 anos, não ter diabete melittus (DM), não fumar e não ter DRC; (Grupo DRC) estar em diálise e clinicamente estável. RESULTADOS: Os níveis de AGEs-sAF aumentaram em função da idade em ambos grupos. O grupo controle apresentou níveis gerais e por faixas etárias de AGEs-sAF menores que o grupo DRC [2,0 (1,7-2,3) vs. 2,7 (2,3-3,4)]; p<0,001).No grupo controle os níveis de AGEs-sAF foi maior entre mulheres [ 2 (1-2,4) vs. 1,9 (1,6-2,3); p=0,001]; observou-se relação inversa entre os níveis de AGEs-sAF e o fototipo da pele (p=0,0001).Hipertensão arterial (HA), fototipo de pele e idade foram variáveis independentes associados aos níveis de AGEs-sAF no grupo controle, enquanto no grupo DRC, idade, fototipo e presença de DM.A correlação entre os níveis de AGEs-sAF e estudos imunohistoquímicos da pele não demonstrou significância estatística. CONCLUSÕES: AGEs-sAF aumentam com a idade e são influenciados pelo fototipo, presença de HAS e DM; os níveis de AGEs-sAF são mais elevados nos pacientes com DRC. Não observamos correlação entre os níveis de AGEs-sAF e a porcentagem de AGEs detectada na pele por estudos de imunohistoquímica.

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Comparison of skin autofluorescence, a marker of tissue advanced glycation end‐products in the fistula and non‐fistula arms of patients treated by hemodialysis

Cited by 4 publications

References 14 publications

Role of skin autofluorescence in managing renal and cardiac diseases in outpatient dermatology

Role of skin autofluorescence in managing renal and cardiac diseases in outpatient dermatology

Is the measurement of tissue advanced glycosylation products by skin autofluorescence associated with mortality in patients treated by peritoneal dialysis?

Estudo de validação do aparelho AGE-Reader em amostra da população brasileira sem e com doença renal crônica

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