Prognostic significance of skin autofluorescence in patients undergoing maintenance hemodialysis
BACKGROUND: Maintenance hemodialysis remains the most common modality of renal replacement therapy, with a consistently high demand. Despite technological advances in recent decades, this high-cost treatment is still associated with a substantial mortality rate. Currently, numerous parameters linked...
Saved in:
| Main Authors: | , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Concilium Medicum
2025-01-01
|
| Series: | КардиоСоматика |
| Subjects: | |
| Online Access: | https://cardiosomatics.ru/2221-7185/article/viewFile/636905/198470 |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1849425534270832640 |
|---|---|
| author | Darya Yu. Konovalova Petr A. Lebedev Andrey A. Loginov Raisa A. Povalyaeva Dmitriy V. Kornilin Vladimir N. Grishanov Marina V. Komarova |
| author_facet | Darya Yu. Konovalova Petr A. Lebedev Andrey A. Loginov Raisa A. Povalyaeva Dmitriy V. Kornilin Vladimir N. Grishanov Marina V. Komarova |
| author_sort | Darya Yu. Konovalova |
| collection | DOAJ |
| description | BACKGROUND: Maintenance hemodialysis remains the most common modality of renal replacement therapy, with a consistently high demand. Despite technological advances in recent decades, this high-cost treatment is still associated with a substantial mortality rate. Currently, numerous parameters linked to poor prognosis have been identified, among which skin autofluorescence represents an accessible method for assessing tissue accumulation of glycation end-products (glycotoxins).
AIM: To determine the prognostic value of skin autofluorescence and its associations with clinical parameters and metabolic disturbances in patients undergoing maintenance hemodialysis.
MATERIALS AND METHODS: A total of 88 patients (47 men) undergoing maintenance hemodialysis were prospectively observed over a mean period of 49 months. The mean age was 58.01±13.79 years. Skin autofluorescence was noninvasively assessed using a specialized reader. All-cause mortality was selected as the primary endpoint.
RESULTS: A significant increase in skin autofluorescence was confirmed in patients receiving maintenance hemodialysis. Skin autofluorescence was found to be determined (R2=46%) by the Charlson comorbidity index, duration of tobacco use (in years), and serum potassium levels. Skin autofluorescence demonstrated statistically significant correlations with parameters of left ventricular hypertrophy and negative correlations with left ventricular ejection fraction. Death occurred in 38 patients, most commonly due to acute cardiovascular failure (23 patients, 61%). Baseline skin autofluorescence level, combined with serum albumin, alkaline phosphatase, and C-reactive protein levels, yielded a prognostic model for all-cause mortality with 72% sensitivity and 84% specificity. A model incorporating skin autofluorescence changes achieved 89% sensitivity, 91% specificity, and 89.9% predictive accuracy.
CONCLUSION: The findings support the use of skin autofluorescence as an integral, independent predictor of all-cause mortality in patients undergoing maintenance hemodialysis. Skin autofluorescence reflects inflammatory and metabolic status, electrolyte imbalances, and cardiovascular remodeling. |
| format | Article |
| id | doaj-art-4c332f2d54c54842bef01ee37e1a367e |
| institution | Kabale University |
| issn | 2221-7185 2658-5707 |
| language | English |
| publishDate | 2025-01-01 |
| publisher | Concilium Medicum |
| record_format | Article |
| series | КардиоСоматика |
| spelling | doaj-art-4c332f2d54c54842bef01ee37e1a367e2025-08-20T03:29:44ZengConcilium MedicumКардиоСоматика2221-71852658-57072025-01-01161849310.17816/CS63690576598Prognostic significance of skin autofluorescence in patients undergoing maintenance hemodialysisDarya Yu. Konovalova0https://orcid.org/0009-0002-2964-2675Petr A. Lebedev1https://orcid.org/0000-0003-3501-2354Andrey A. Loginov2https://orcid.org/0009-0009-6167-5507Raisa A. Povalyaeva3https://orcid.org/0009-0008-9387-508XDmitriy V. Kornilin4https://orcid.org/0000-0002-0694-4016Vladimir N. Grishanov5https://orcid.org/0000-0002-6675-4396Marina V. Komarova6https://orcid.org/0000-0001-6545-0035Samara State Medical UniversitySamara State Medical UniversitySeredavin Samara Regional Clinical HospitalSeredavin Samara Regional Clinical HospitalKorolev Samara National Research UniversityKorolev Samara National Research UniversityKorolev Samara National Research UniversityBACKGROUND: Maintenance hemodialysis remains the most common modality of renal replacement therapy, with a consistently high demand. Despite technological advances in recent decades, this high-cost treatment is still associated with a substantial mortality rate. Currently, numerous parameters linked to poor prognosis have been identified, among which skin autofluorescence represents an accessible method for assessing tissue accumulation of glycation end-products (glycotoxins). AIM: To determine the prognostic value of skin autofluorescence and its associations with clinical parameters and metabolic disturbances in patients undergoing maintenance hemodialysis. MATERIALS AND METHODS: A total of 88 patients (47 men) undergoing maintenance hemodialysis were prospectively observed over a mean period of 49 months. The mean age was 58.01±13.79 years. Skin autofluorescence was noninvasively assessed using a specialized reader. All-cause mortality was selected as the primary endpoint. RESULTS: A significant increase in skin autofluorescence was confirmed in patients receiving maintenance hemodialysis. Skin autofluorescence was found to be determined (R2=46%) by the Charlson comorbidity index, duration of tobacco use (in years), and serum potassium levels. Skin autofluorescence demonstrated statistically significant correlations with parameters of left ventricular hypertrophy and negative correlations with left ventricular ejection fraction. Death occurred in 38 patients, most commonly due to acute cardiovascular failure (23 patients, 61%). Baseline skin autofluorescence level, combined with serum albumin, alkaline phosphatase, and C-reactive protein levels, yielded a prognostic model for all-cause mortality with 72% sensitivity and 84% specificity. A model incorporating skin autofluorescence changes achieved 89% sensitivity, 91% specificity, and 89.9% predictive accuracy. CONCLUSION: The findings support the use of skin autofluorescence as an integral, independent predictor of all-cause mortality in patients undergoing maintenance hemodialysis. Skin autofluorescence reflects inflammatory and metabolic status, electrolyte imbalances, and cardiovascular remodeling.https://cardiosomatics.ru/2221-7185/article/viewFile/636905/198470skin autofluorescencemaintenance hemodialysisprognosisall-cause mortalitycardiovascular mortality |
| spellingShingle | Darya Yu. Konovalova Petr A. Lebedev Andrey A. Loginov Raisa A. Povalyaeva Dmitriy V. Kornilin Vladimir N. Grishanov Marina V. Komarova Prognostic significance of skin autofluorescence in patients undergoing maintenance hemodialysis КардиоСоматика skin autofluorescence maintenance hemodialysis prognosis all-cause mortality cardiovascular mortality |
| title | Prognostic significance of skin autofluorescence in patients undergoing maintenance hemodialysis |
| title_full | Prognostic significance of skin autofluorescence in patients undergoing maintenance hemodialysis |
| title_fullStr | Prognostic significance of skin autofluorescence in patients undergoing maintenance hemodialysis |
| title_full_unstemmed | Prognostic significance of skin autofluorescence in patients undergoing maintenance hemodialysis |
| title_short | Prognostic significance of skin autofluorescence in patients undergoing maintenance hemodialysis |
| title_sort | prognostic significance of skin autofluorescence in patients undergoing maintenance hemodialysis |
| topic | skin autofluorescence maintenance hemodialysis prognosis all-cause mortality cardiovascular mortality |
| url | https://cardiosomatics.ru/2221-7185/article/viewFile/636905/198470 |
| work_keys_str_mv | AT daryayukonovalova prognosticsignificanceofskinautofluorescenceinpatientsundergoingmaintenancehemodialysis AT petralebedev prognosticsignificanceofskinautofluorescenceinpatientsundergoingmaintenancehemodialysis AT andreyaloginov prognosticsignificanceofskinautofluorescenceinpatientsundergoingmaintenancehemodialysis AT raisaapovalyaeva prognosticsignificanceofskinautofluorescenceinpatientsundergoingmaintenancehemodialysis AT dmitriyvkornilin prognosticsignificanceofskinautofluorescenceinpatientsundergoingmaintenancehemodialysis AT vladimirngrishanov prognosticsignificanceofskinautofluorescenceinpatientsundergoingmaintenancehemodialysis AT marinavkomarova prognosticsignificanceofskinautofluorescenceinpatientsundergoingmaintenancehemodialysis |