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Skin autofluorescence and all-cause mortality in Stage 3 CKD

Skin autofluorescence and all-cause mortality in Stage 3 CKD
Skin autofluorescence and all-cause mortality in Stage 3 CKD
Background and objectives: novel markers may help to improve risk prediction in CKD. One potential candidate is tissue advanced glycation end product accumulation, a marker of cumulative metabolic stress, which can be assessed by a simple noninvasive measurement of skin autofluorescence. Skin autofluorescence correlates with higher risk of cardiovascular events and mortality in people with diabetes or people requiring RRT, but its role in earlier CKD has not been studied.

Design, setting, participants, & measurements: prospective cohort of 1741 people with CKD stage 3 was recruited from primary care between August 2008 and March 2010. Participants underwent medical history, clinical assessment, blood and urine sampling for biochemistry, and measurement of skin autofluorescence. Kaplan–Meier plots and multivariate Cox proportional hazards models were used to investigate associations between skin autofluorescence (categorical in quartiles) and all-cause mortality.

Results: in total, 1707 participants had skin autofluorescence measured; 170 (10%) participants died after a median of 3.6 years of follow-up. The most common cause of death was cardiovascular disease (41%). Higher skin autofluorescence was associated significantly with poorer survival (all-cause mortality, P<0.001) on Kaplan–Meier analysis. Univariate and age/sex-adjusted Cox proportional hazards models showed that the highest quartile of skin autofluorescence was associated with all-cause mortality (hazard ratio, 2.64; 95% confidence interval, 1.71 to 4.08; P<0.001 and hazard ratio, 1.84; 95% confidence interval, 1.18 to 2.86; P=0.003, respectively, compared with the lowest quartile). This association was not maintained after additional adjustment to include cardiovascular disease, diabetes, smoking, body mass index, eGFR, albuminuria, and hemoglobin.

Conclusions: skin autofluorescence was not independently associated with all-cause mortality in this study. Additional research is needed to clarify whether it has a role in risk prediction in CKD
1555-9041
Fraser, Simon D.S.
135884b6-8737-4e8a-a98c-5d803ac7a2dc
Roderick, Paul J.
dbb3cd11-4c51-4844-982b-0eb30ad5085a
McIntyre, Natasha J.
8d50caa9-9893-4f6c-9101-9207f5eaa331
Harris, Scott
c7cca691-f4d3-4d84-a928-24ecd7c33bad
McIntyre, Christopher W.
567b8ae4-b1dc-4792-bad0-f6dee73305d6
Fluck, Richard J.
fedcd5a4-5459-461f-bef0-3747f4a3757d
Taal, Maarten W.
10eeea62-a2fc-43b6-b5af-359e75c501ea
Fraser, Simon D.S.
135884b6-8737-4e8a-a98c-5d803ac7a2dc
Roderick, Paul J.
dbb3cd11-4c51-4844-982b-0eb30ad5085a
McIntyre, Natasha J.
8d50caa9-9893-4f6c-9101-9207f5eaa331
Harris, Scott
c7cca691-f4d3-4d84-a928-24ecd7c33bad
McIntyre, Christopher W.
567b8ae4-b1dc-4792-bad0-f6dee73305d6
Fluck, Richard J.
fedcd5a4-5459-461f-bef0-3747f4a3757d
Taal, Maarten W.
10eeea62-a2fc-43b6-b5af-359e75c501ea

Fraser, Simon D.S., Roderick, Paul J., McIntyre, Natasha J., Harris, Scott, McIntyre, Christopher W., Fluck, Richard J. and Taal, Maarten W. (2014) Skin autofluorescence and all-cause mortality in Stage 3 CKD. Clinical Journal of the American Society of Nephrology, 9. (doi:10.2215/CJN.09510913).

Record type: Article

Abstract

Background and objectives: novel markers may help to improve risk prediction in CKD. One potential candidate is tissue advanced glycation end product accumulation, a marker of cumulative metabolic stress, which can be assessed by a simple noninvasive measurement of skin autofluorescence. Skin autofluorescence correlates with higher risk of cardiovascular events and mortality in people with diabetes or people requiring RRT, but its role in earlier CKD has not been studied.

Design, setting, participants, & measurements: prospective cohort of 1741 people with CKD stage 3 was recruited from primary care between August 2008 and March 2010. Participants underwent medical history, clinical assessment, blood and urine sampling for biochemistry, and measurement of skin autofluorescence. Kaplan–Meier plots and multivariate Cox proportional hazards models were used to investigate associations between skin autofluorescence (categorical in quartiles) and all-cause mortality.

Results: in total, 1707 participants had skin autofluorescence measured; 170 (10%) participants died after a median of 3.6 years of follow-up. The most common cause of death was cardiovascular disease (41%). Higher skin autofluorescence was associated significantly with poorer survival (all-cause mortality, P<0.001) on Kaplan–Meier analysis. Univariate and age/sex-adjusted Cox proportional hazards models showed that the highest quartile of skin autofluorescence was associated with all-cause mortality (hazard ratio, 2.64; 95% confidence interval, 1.71 to 4.08; P<0.001 and hazard ratio, 1.84; 95% confidence interval, 1.18 to 2.86; P=0.003, respectively, compared with the lowest quartile). This association was not maintained after additional adjustment to include cardiovascular disease, diabetes, smoking, body mass index, eGFR, albuminuria, and hemoglobin.

Conclusions: skin autofluorescence was not independently associated with all-cause mortality in this study. Additional research is needed to clarify whether it has a role in risk prediction in CKD

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More information

e-pub ahead of print date: 29 May 2014
Published date: 29 May 2014
Organisations: Primary Care & Population Sciences

Identifiers

Local EPrints ID: 365477
URI: https://eprints.soton.ac.uk/id/eprint/365477
ISSN: 1555-9041
PURE UUID: fc22ce2a-f03d-4ae8-a2a8-c55dc0970d09
ORCID for Simon D.S. Fraser: ORCID iD orcid.org/0000-0002-4172-4406
ORCID for Paul J. Roderick: ORCID iD orcid.org/0000-0001-9475-6850

Catalogue record

Date deposited: 05 Jun 2014 11:50
Last modified: 20 Jul 2019 01:19

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