Skin autofluorescence in the integral assessment of clinical and metabolic status of patients with terminal chronic kidney disease

BACKGROUND: Chronic kidney disease (CKD) is a common disease that terminally requires kidney transplantation or dialysis, the predominant type of which is program hemodialysis (PHD). These high-cost technologies have largely improved in recent decades, but quality of life and mortality are still high, especially for patients receiving PHD. A number of parameters associated with a negative prognosis have now been identified, among which the skin autofluorescence (SAF)-a parameter that is an accessible way to detect glycation end products (glycotoxins) in tissues, claiming to be an integral biomarker. AIM: In order to establish the relationships of SAF with the parameters of clinical, metabolic status in patients receiving renal replacement therapy. MATERIAL AND METHODS: The 88 patients receiving PHD and 27 patients with renal transplantion (RT) were studied. The original SAF reader was used in the paper. RESULTS: SAF was significantly higher in RTptsand those receiving PHD. A universal pronounced dependence of SAF on age and smoking was found in control, PHD and RT groups. Models of SAF determinants in each studied group were proposed. SAF was associated with the degree of nutritional deficiency (by NRI index) r=-0.39, p0.001 and Charlson comorbidity index: r=0.60, p0.0001, inflammation by C-r protein: r=0,32, p0,01 in the PHD group. CONCLUSION: Models of ROS determinants in each studied group are proposed. Also in this group highly significant direct correlations with parameters of left ventricular hypertrophy and negative correlations with its ejection fraction were established. These facts allow us to consider SAF as an integral parameter of cardiac remodeling and metabolism impairment, mainly in PHD, proposing its significance as prognostic trait.