Skin autofluorescence as a measure of advanced glycation endproduct deposition: a novel risk marker in chronic kidney disease

Curr Opin Nephrol Hypertens. 2010 Nov;19(6):527-33. doi: 10.1097/MNH.0b013e32833e9259.

Abstract

Purpose of review: Skin autofluorescence (SAF) is a new method to noninvasively assess accumulation of advanced glycation endproducts (AGEs) in a tissue with low turnover. Recent progress in the clinical application of SAF as a risk marker for diabetic nephropathy as well as cardiovascular disease in nondiabetic end-stage kidney disease, less advanced chronic kidney disease, and renal transplant recipients is reviewed.

Recent findings: Experimental studies highlight the fundamental role of the interaction of AGEs with the receptor for AGEs (RAGEs), also called the AGE-RAGE axis, in the pathogenesis of vascular and chronic kidney disease. SAF predicts (cardiovascular) mortality in renal failure and also chronic renal transplant dysfunction. Long-term follow-up results from the Diabetes Control and Complications Trial and UK Prospective Diabetes Study suggest that AGE accumulation is a key carrier of metabolic memory and oxidative stress. Short-term intervention studies in diabetic nephropathy with thiamine, benfotiamine and angiotensin-receptor blockers aimed at reducing AGE formation have reported mixed results.

Summary: SAF is a noninvasive marker of AGE accumulation in a tissue with low turnover, and thereby of metabolic memory and oxidative stress. SAF independently predicts cardiovascular and renal risk in diabetes, as well as in chronic kidney disease. Further long-term studies are required to assess the potential benefits of interventions to reduce AGE accumulation.

Publication types

  • Review

MeSH terms

  • Biomarkers / metabolism
  • Chronic Disease
  • Glycation End Products, Advanced / metabolism*
  • Humans
  • Kidney Diseases / metabolism*
  • Predictive Value of Tests
  • Prognosis
  • Risk Assessment
  • Risk Factors
  • Skin / metabolism*
  • Spectrometry, Fluorescence*
  • Time Factors

Substances

  • Biomarkers
  • Glycation End Products, Advanced