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CVD remains the major cause of death for dialysis patients. Dialysis patients have both traditional and nontraditional risk factors, including the retention of advanced glycation end products (AGE). Tissue AGE can be measured by skin autofluorescence (SAF) and are a reliable measurement of chronic exposure. Dietary intake of AGE may be lower in vegetarian patients than in non-vegetarian patients, so we determined whether vegetarian patients had lower SAF than non-vegetarian patients. We measured SAF in 332 adult haemodialysis patients using a UV technique in a standardised manner. Information about patients' demographic data, laboratory results and current medicinal prescriptions was collected retrospectively from the hospital's computerised database. The mean patient age was 65·2 (sd 15·1) years, 64 % were men, 42 % were diabetic, and 66 % were Caucasian. The mean SAF was 3·26 (sd 0·95) arbitrary units (AU), and SAF was lower in vegetarians as compared to non-vegetarians (2·71 (sd 0·6) v. 3·31 (sd 0·97) AU, P= 0·002). SAF was negatively correlated on both univariate (r − 0·17, P= 0·002) and multiple linear regression (β coefficient − 0·39, 95 % CI − 0·7, − 0·07, P= 0·019). SAF, a marker of tissue AGE deposition, was reduced in vegetarian haemodialysis patients after correction for known confounders, which suggests that a vegetarian diet may reduce exposure to preformed dietary AGE. Dietary manipulation could potentially reduce tissue AGE and SAF as well as CVD risk, but further prospective studies are warranted to confirm the present findings. [ABSTRACT FROM PUBLISHER]

Aim: Skin autofluoresence has been advocated as a quick non-invasive method of measuring tissue advanced glycosylation end products (AGE), which have been reported to correlate with cardiovascular risk in the dialysis patient. Most studies have been performed in patients from a single racial group, and we wanted to look at the reliability of skin autofluoresence measurements in a multiracial dialysis population and whether results were affected by haemodialysis., Methods: We measured skin autofluoresence three times in both forearms of 139 haemodialysis patients pre-dialysis and 36 post-dialysis., Results: One hundred and thirty-nine patients, 62.2% male, 35.3% diabetic, 59% Caucasoid, mean age 65.5 ± 15.2 years were studied. Reproducibility of measurements between the 1st and 2nd measurements was very good (r(2 ) = 0.94, P < 0.001, Bland Altman bias 0.05, confidence limits -0.02 to 0.04). However, skin autoflourescence measurements were not possible in one forearm in 8.5% Caucasoids, 25% Far Asian, 28% South Asians and 75% African or Afro Caribbean (P < 0.001). Mean skin autofluorescence in the right forearm was 3.3 ± 0.74 arbitrary units (AU) and left forearm 3.18 ± 0.82 AU pre-dialysis, and post-dialysis there was a fall in those patients dialysing with a left sided arteriovenous fistula (left forearm pre 3.85 ± 0.72 vs post 3.36 ± 0.55 AU, P = 0.012)., Conclusion: Although skin autofluorescence is a relatively quick non-invasive method of measuring tissue AGE and measurements were reproducible, it was often not possible to obtain measurements in patients with highly pigmented skin. To exclude potential effects of arteriovenous fistulae we would suggest that measurements are made in the non-fistula forearm pre-dialysis., (© 2013 The Authors. Nephrology © 2013 Asian Pacific Society of Nephrology.)