Skin autofluorescence as a marker of cardiovascular risk in children with chronic kidney disease

Background We examined skin autofluorescence (sAF) in chronic kidney disease children (CKD) in relation to renal function and dialysis modality. Methods Twenty children on hemodialysis (HD), 20 on peritoneal dialysis (PD), 36 treated conservatively, and 26 healthy subjects were enrolled into the stu...

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Published in:Pediatric nephrology (Berlin, West) West), 2013-01, Vol.28 (1), p.121-128
Main Authors: Makulska, Irena, Szczepańska, Maria, Drożdż, Dorota, Polak-Jonkisz, Dorota, Zwolińska, Danuta
Format: Article
Language:English
Subjects:
Adolescent
Cardiovascular disease
Cardiovascular diseases
Cardiovascular Diseases - complications
Care and treatment
Chronic kidney failure
Cross-Sectional Studies
Diabetes
Diagnosis
Female
Glycation End Products, Advanced - metabolism
Hemodialysis
Homocysteine
Humans
Kidney diseases
Male
Medicine
Medicine & Public Health
Morbidity
Mortality
Nephrology
Optical Imaging
Original
Original Article
Oxidative stress
Pediatrics
Peritoneal dialysis
Renal Insufficiency, Chronic - complications
Renal Insufficiency, Chronic - metabolism
Renal replacement therapy
Risk Factors
Skin
Skin - metabolism
Urology
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Summary:Background We examined skin autofluorescence (sAF) in chronic kidney disease children (CKD) in relation to renal function and dialysis modality. Methods Twenty children on hemodialysis (HD), 20 on peritoneal dialysis (PD), 36 treated conservatively, and 26 healthy subjects were enrolled into the study. In all children sAF, pulse-wave velocity indexed to height (PWV/ht), left ventricular mass index (LVMI), blood pressure (BP), serum lipid profile, phosphate (P), calcium (Ca), and homocysteine were measured. Results sAF was significantly elevated in CKD groups vs. controls and was significantly associated with PWV/ht, LVMI, BP, P, Ca × P product and homocysteine. sAF in HD and PD groups was positively correlated with dialysis vintage, and in the predialysis group negatively correlated with glomerular filtration rate (eGFR). Multiple regression analysis showed significant association of sAF with LVMI and P in the CKD patient group, and with dialysis treatment duration and BP in dialyzed children. Conclusions In CKD children, tissue accumulation of advanced glycation end-products (AGEs) was observed. This was aggravated as eGFR declined and was related to early cardiovascular changes and some biochemical cardiovascular disease (CVD) risk markers. sAF as a non-invasive method may be a useful tool for identification of a clinical risk factors of cardiovascular disease in CKD children.
ISSN:0931-041X
1432-198X
DOI:10.1007/s00467-012-2280-z