Advanced glycation end-products: new markers of renal dysfunction in patients with chronic heart failure

Background and objectives: Advanced glycation end-products (AGE) are implicated in the physiopathology and prognosis of heart failure (HF) and they accumulate in situations such as kidney failure (KF). Our objective was to analyze the relation between AGE and KF in patients with chronic HF. Materials and methods: 102 consecutive patients of our medical center were included. Clinical and analytical data were obtained, with measurement of glycated haemoglobin, brain natriuretic peptide, cystatin C and fluorescent AGE. Glomerular filtration rate (GFR) was estimated for each patient. Results: 40.2% of patients presented GFR < 60 mL/min/1.73m(2) and 11.7% had hidden kidney disease (HKD). AGE correlated positively with creatinine (r = 0.685, p < 0.001) and cystatin C (r = 0.682, p < 0.001) and negatively with GFR (r = -0.720, p < 0.001). Medium value of fluorescent AGE in patients with KF was higher than those without KF (83.4 [3.3] URF vs 56.8 [2.1] URF, p < 0.001). With regard to the diagnostic value for HKD, fluorescent AGE presented an area under the ROC curve higher than other parameters for KD such as cystatin C. In the multivariate analysis, fluorescent AGE were an independent biomarker of KD (OR 1.060; 95% CI 1.024-1.097; p = 0.001). Conclusions: AGE act as a biomarker of KD in patients with chronic HP, both diabetics and non diabetics, being better than cystatin C in the detection of HKD. (C) 2010 Elsevier Espana, S.L. All rights