Skin- and Plasmaautofluorescence in hemodialysis with glucose-free or glucose-containing dialysate

• Background: Haemodialysis (HD) patients suffer from an increased risk of cardiovascular disease (CVD). Skinautofluorescence (SAF) is a strong marker for CVD. SAF indirectly measures tissue advanced glycation end products(AGE) being cumulative metabolites of oxidative stress and cytokine-driven inflammatory reactions. The dialysatesoften contain glucose.Methods: Autofluorescence of skin and plasma (PAF) were measured in patients on HD during standard treatment(ST) with a glucose-containing dialysate (n = 24). After that the patients were switched to a glucose-free dialysate(GFD) for a 2-week period. New measurements were performed on PAF and SAF after 1 week (M1) and 2 weeks(M2) using GFD. Nonparametric paired statistical analyses were performed between each two periods.Results: SAF after HD increased non-significantly by 1.2% while when a GFD was used during HD at M1, a decreaseof SAF by 5.2% (p = 0.002) was found. One week later (M2) the reduction of 1.6% after the HD was not significant(p = 0.33). PAF was significantly reduced during all HD sessions. Free and protein-bound PAF decreased similarlywhether glucose containing or GFD was used. The HD resulted in a reduction of the total PAF of approximately15%, the free compound of 20% and the protein bound of 10%. The protein bound part of PAF correspondedto approximately 56% of the total reduction. The protein bound concentrations after each HD showed thelowest value after 2 weeks using glucose-free dialysate (p < 0.05). The change in SAF could not be related to achange in PAF.Conclusions: When changing to a GFD, SAF was reduced by HD indicating that such measure may hamperthe accumulation and progression of deposits of AGEs to protein in tissue, and thereby also the developmentof CVD. Glucose-free dialysate needs further attention. Protein binding seems firm but not irreversible.

Ämnesord

MEDICIN OCH HÄLSOVETENSKAP  -- Klinisk medicin -- Urologi och njurmedicin (hsv//swe)

MEDICAL AND HEALTH SCIENCES  -- Clinical Medicine -- Urology and Nephrology (hsv//eng)

Nyckelord

Haemodialysis

Plasma autofluorescence

Skin autofluorescence

Glucose free dialysate

Publikations- och innehållstyp

ref (ämneskategori)

art (ämneskategori)