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Abstract: FR-PO514

Advanced Glycation End-Products (AGEs) Accumulation and Skeletal Complications in CKD Patients

Session Information

Category: Bone and Mineral Metabolism

  • 401 Bone and Mineral Metabolism: Basic

Authors

  • Roza, Noemi Angelica Vieira, School of Medical Sciences, Campinas, Brazil
  • Quadros, Kelcia Rosana da Silva, School of Medical Sciences, Campinas, Brazil
  • Esteves, André Barros Albuquerque, School of Medical Sciences, Campinas, Brazil
  • Franca, Renata Almeida, School of Medical Sciences, Campinas, Brazil
  • Borges, Cynthia Moura, School of Medical Sciences, Campinas, Brazil
  • Carbonara, Cinthia Esbrile Moraes, School of Medical Sciences, Campinas, Brazil
  • Antonialli, Fabiana Sampaio, School of Medical Sciences, Campinas, Brazil
  • dos Reis, Luciene, University of Sao Paulo - Medical School - Nephrology Division, Sao Paulo, Brazil
  • Jorgetti, Vanda, University of Sao Paulo - Medical School - Nephrology Division, Sao Paulo, Brazil
  • de Oliveira, Rodrigo B., School of Medical Sciences, Campinas, Brazil

Group or Team Name

  • Laboratory for Evaluation of Mineral and Bone Disorder in Nephrology (LEMON)
Background

Chronic kidney disease (CKD) has high rates of mortality related to uremic toxins and bone complications. Fractures risk is higher in CKD patients than general population and is dependent of cortical bone quality. We aim to investigate the relationships between advanced glycation end-products (AGEs) and bone in a cohort of patients at different stages of CKD.

Methods

86 CKD patients (stages 3-4, N=26; hemodialysis, N=32; peritoneal dialysis, N=28) were included. AGEs levels were measured in serum (for glycated hemoglobin and pentosidine), skin (through AGE-Reader device), and cortical bone (by immunohistochemistry). Fracture risk was predicted using FRAX tool. Bone histomorphometry was performed to measure cortical porosity, thickness and volume.

Results

Age was 51±13 yrs., 48 (56%) male, 41 (48%) Caucasian and 16 (19%) diabetics; GFR was 6 (5-17) mL/min, body mass index (BMI) was 26±5 kg/m2 and waist circumference 92±12 cm. AGEs levels in skin were 3.0±0.7 AU (reference: < 2.0 AU) and were positively correlated with age (R=0.68; P=0.001), glycated hemoglobin (R=0.28; P=0.04), risk for major osteoporotic fracture (R=0.54; P=0.001), hip fractures (R=0.53; P=0.001), Framingham risk (R=0.53; P=0.001). AGEs deposition in cortical bone were positively correlated with major osteoporotic fracture risk (R=0.50; P=0.001). Cortical thickness were negatively correlated with serum pentosidine (R=-0.30; P=0.04) and glycated hemoglobin levels (R=-0.31; P=0.03), Framingham Risk (R=-0.33; P=0.02), age (R=-0.43; P=0.03), BMI (R=-0.43; P=0.03), waist circumference (R=-0.38; P=0.01), and LDL-cholesterol (R=-0.34; P=0.02). Cortical porosity were positively correlated with cholesterol levels (R=0.30; P=0.04) and Framingham Risk (R=0.32; P=0.03).

Conclusion

AGEs were detected in cortical bone of CKD patients at different stages and correlates with their risk for major osteoporotic fractures; this risk was also related with AGEs accumulation in skin. Serum levels of pentosidine and glycated hemoglobin were associated to low thickness of cortical bone. Finally, there seems to be a relationship between poor quality of cortical bone and factors linked to cardiovascular disease.

Funding

  • Government Support - Non-U.S.