Abstract: SA-PO176

Tissue Content of Advanced Glycation End-Products and Augmentation Index, a Marker of Vascular Stiffness, Are Linked to Cardiovascular Disease and Mortality in CKD Patients

Session Information

Category: Nutrition, Inflammation, and Metabolism

  • 1401 Nutrition, Inflammation, Metabolism

Authors

  • Mukai, Hideyuki, Karolinska Institutet, Stockholm, Sweden
  • Lindholm, Bengt, Karolinska Institutet, Stockholm, Sweden
  • Lu, Dai, Karolinska Institutet, Stockholm, Sweden
  • Ripsweden, Jonaz, Karolinska Institutet, Stockholm, Sweden
  • Brismar, Torkel, Karolinska Institutet, Stockholm, Sweden
  • Heimburger, Olof, Karolinska Institutet, Stockholm, Sweden
  • Barany, Peter F., Karolinska Institutet, Stockholm, Sweden
  • Stenvinkel, Peter, Karolinska Institutet, Stockholm, Sweden
  • Qureshi, Abdul Rashid Tony, Karolinska Institutet, Stockholm, Sweden
Background

Accumulation of advanced glycation end-products (AGEs) may contribute to cardiovascular disease (CVD) and increased mortality in chronic kidney disease (CKD) patients. Skin autofluorescence (SAF), a noninvasive measurement of tissue AGE accumulation, and augmentation index (Aix) by applanation tonometry, may be markers of vascular damage and arterial stiffness respectively. We investigated associations of SAF, AIx and Framingham’s CVD risk score with mortality in CKD patients.

Methods

SAF (AGE Reader) and Aix (SphygmoCor; adjusted for 75 heart beats per minute) were measured in 261 CKD patients (median age 56 years, 66% male, 20% diabetes; 130 non-dialyzed, 93 on peritoneal dialysis and 38 on hemodialysis). In 201 patients, coronary artery calcium score was assessed by computed tomography. Associations of SAF, AIx, and Framingham’s CVD risk score (FRS) with all-cause mortality was evaluated by multivariate Cox models. During follow-up for median 25 months, there were 46 deaths.

Results

SAF associated with FRS (rho=0.51), hsCRP (rho=0.31), handgrip strength, HGS (rho=-0.30), fat body mass index, FBMI (rho=0.24), and bone mineral density, BMD (rho=-0.22). AIx associated with HGS (rho=-0.43), FRS (rho=0.41), albumin (rho=-0.26), hsCRP (rho=0.25), BMD (rho=-0.23) and lean body mass index, LBMI (rho=-0.20). ROC curve analysis of classifiers of CVD and predictors all-cause mortality showed as expected high values for FRS (AUC=0.75 and 0.77), however closely followed by SAF (AUC=0.71 and 0.75) and AIx (AUC=0.64 and 0.70). The highest tertile of Aix associated with all-cause mortality, HR 2.52 (95% CI 0.98-6.46; p=0.05), after adjusting for FRS.

Conclusion

SAF and AIx were associated with presence of CVD and mortality in ROC curve analysis; however, only AIx - and not SAF associated (p=0.05) with increased mortality risk after adjusting for Framingham’s CVD risk score in CKD patients.

Funding

  • Commercial Support