PhD ceremony Mr. S. Arsov: Advanced glycation end-products in hemodialysis patients

PhD ceremony: Mr. S. Arsov, 12.45 uur, Academiegebouw, Broerstraat 5, Groningen

Dissertation: Advanced glycation end-products in hemodialysis patients

Promotor(s): prof. G. Rakhorst, prof. A.J. Smit

Faculty: Medical Sciences

End-stage renal disease (ESRD) represents a serious health and social problem. In this thesis we focused on hemodialysis (HD), the most frequently used method of renal replacement therapy in ESRD patients. Advanced Glycation End-products (AGEs) are metabolic end-products that belong to the group of protein-bound uremic toxins. Skin AGEs can be measured by means of Skin Autoflourescence (AF). This dissertation aimed at finding factors that influence the skin and plasma AGEs and possible strategies in reducing the AGEs levels in HD patients.

The mean one year increase of Skin AF of the HD patients was around 7-9 fold higher than of healthy subjects. One year increase of Skin AF proved to be a strong predictor of mortality in HD patients. Although plasma AF decreased significantly after a single HD session, this did not lead to instant differences in Skin AF. AGEs accumulation measured by means of Skin AF did not differ in HD patients with and without hepatitis C. It appeared that calorie, protein and AGEs intake hardly influenced the one year increase of Skin AF in HD patients. However, Body Mass Index (BMI) was a predictor of the one year increase of Skin AF which is a strong predictor of mortality of HD patients. The BMI of HD patients of around 24 kg/m² resulted in the lowest one year increase of Skin AF.

It appears that optimizing the nutritional level of HD patients might result in reduced accumulation of AGEs and thus reducing the mortality risk of these patients.