Kidney Week

Abstract: TH-PO941

Advanced Glycation End Products (AGEs) by Skin Autofluorescence (SAF) in Renal Transplant (TxR): Risk and Influence in Clinical Practice

Session Information

• Transplantation: AKI, Cardiovascular, and Metabolic Complications
  November 02, 2017 | Location: Hall H, Morial Convention Center
  Abstract Time: 10:00 AM - 10:00 AM

Category: Transplantation

• 1702 Transplantation: Clinical and Translational

Authors

• Cigarran, Secundino, Eoxi Cervo-Lugo-Monforte, Burela, Lugo, Spain

Secundino Cigarran,

• Gonzalez tabares, Lourdes, Eoxi Cervo-Lugo-Monforte, Lugo, Spain

Lourdes Gonzalez tabares,

• Menendez, Nicolas, Eoxi Cervo-Lugo-Monforte, Burela, Lugo, Spain

Nicolas Menendez,

• Latorre, Juan, Eoxi Cervo-Lugo-Monforte, Burela, Lugo, Spain

Juan Latorre,

• Cobelo casas, Carmen Raquel, Eoxi Cervo-Lugo-Monforte, Lugo, Spain

Carmen Raquel Cobelo casas,

• Millan, Beatriz, Eoxi Cervo-Lugo-Monforte, Lugo, Spain

Beatriz Millan,

• López, Nuria Callejo, Eoxi Cervo-Lugo-Monforte, Burela, Lugo, Spain

Nuria Callejo López,

• Cillero, Sonia, Eoxi Cervo-Lugo-Monforte, Lugo, Spain

Sonia Cillero,

• Sanjurjo amado, Ana maria, Eoxi Cervo-Lugo-Monforte, Burela, Lugo, Spain

Ana maria Sanjurjo amado,

• Calvino, Jesus, Eoxi Cervo-Lugo-Monforte, Lugo, Spain

Jesus Calvino,

Background

AGEs accumulation constitute a vascular pathogenic mechanism involved in aging, diabetes and chronic kidney disease (CKD) moreover of being a measure of cumulative metabolic stress.Despite removal of uremic toxins&AGEs after a succesful TxR, cardiovascular disease (CVD) remains the leading cause of mortality. Our aim was to evaluate AGEs by SAF in TxR and its relation with markers associated to CV risk.

Methods

191 stable TxR were analyzed (38.7% women, aged 56±13.1 years). All were on CKD stages1-4 and > 12 months of transplantation. Variables assessed: diabetes,CVD history,subclinical atheromatosis by arm-ankle-index and allograft resistivity index, 24-h ABPM, anthropometric and nutritional markers (including dynamometry),biochemical (hemoglobin, albumin, transferrin, CKD-EPI, Ca, P, iPTH, vitamin D and C reactive protein).Urinalysis included ACR (mg/gr) and phosphorus tubular reabsortion (RTP,%).AGEs were measured by SAF. Vascular age was estimated by Koetsier formula (AFD-0.83/0.024) and estimated 10-years cardiovascular death risk by REGICOR formula.

Results

Mean SAF was 2.99±0.83 UA and estimated vascular age was 90±34.6 years (30 years above biological).After univariable analysis,SAF was higher in men (3.1±0.90 vs 2.8±0.67,p<.001),diabetic (3.2±0.86 vs 2.9±0.81,p<.001) and steroids use (3.1±0.91vs2.7±0.71 p<.001).A positive correlation with night SBP (r=0.240 p<.005),iPTH (r=0.210 p<.001),P (r=0.300 p<.005) and negative with hemoglobin (r=-0.310 p<.005),CKD-EPI (r=-0.350 p<.005) & RTP (r=-0.263 p<.005).Nutritional parameters&AGEs showed a negative correlation with albumin, transferrin,arm circumference & dynamometry (r=-0.200 p<.005).AGEs also showed correlation with subclinical vascular atheromatosis as well as with REGICOR scale (r=0.400 p<.001).After multivariate analysis significant variables were:age,male ,steroid use,P and dynamometry.

Conclusion

SAF is a validated, economic,and non-invasive tool to assess cardiovascular risk in TxR.Besides age and male gender,our results suggest that P overload,steroid use and nutritional status are the main significant determinants that promote AGEs accumulation.Further longitudinal studies are required in order to confirm this hypothesis.

Funding

• Other NIH Support