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Glycated hemoglobin or glycated albumin for assessment of glycemic control in hemodialysis patients with diabetes?

Abstract

This commentary discusses the findings of a study by Peacock et al., who measured levels of glycated hemoglobin (HbA1c) and glycated albumin in patients with diabetes who either were or were not on hemodialysis in an effort to determine which marker is the better indicator of glycemic control. They found that HbA1c and glycated albumin levels are both independently associated with serum glucose level. However, HbA1c level—unlike glycated albumin level—was also influenced by hemodialysis, hemoglobin level, and erythropoietin dose. Although we agree that glycated albumin level could be a better indicator of glycemic control than HbA1c level in patients on hemodialysis who have diabetes and anuria, this conclusion might not be applicable to patients with massive proteinuria or to those on peritoneal dialysis. Further studies are required to confirm the target glycated albumin level that is necessary to ensure a good prognosis for patients with diabetes who are on hemodialysis because no clear consensus has yet been reached. In addition, more data are needed to determine at which stage of kidney disease measurement of glycated albumin levels becomes preferable to assessment of HbA1c level.

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References

  1. Gaede P et al. (2003) Multifactorial intervention and cardiovascular disease in patients with type 2 diabetes. N Engl J Med 348: 383–393

    Article  Google Scholar 

  2. Morioka T et al. (2001) Glycemic control is a predictor of survival for diabetic patients on hemodialysis. Diabetes Care 24: 909–913

    CAS  Article  Google Scholar 

  3. Inaba M et al. (2007) Glycated albumin is a better glycemic indicator than glycated hemoglobin values in hemodialysis patients with diabetes: effect of anemia and erythropoietin injection. J Am Soc Nephrol 18: 896–903

    CAS  Article  Google Scholar 

  4. Joy MS et al. (2002) Long-term glycemic control measurements in diabetic patients receiving hemodialysis. Am J Kidney Dis 39: 297–307

    Article  Google Scholar 

  5. Pisoni RL et al. (2004) Anemia management and outcomes from 12 countries in the Dialysis Outcomes and Practice Patterns Study (DOPPS). Am J Kidney Dis 44: 94–111

    Article  Google Scholar 

  6. Peacock TP et al. (2008) Comparison of glycated albumin and hemoglobin A1c levels in diabetic subjects on hemodialysis. Kidney Int 73: 1062–1068

    CAS  Article  Google Scholar 

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Correspondence to Masanori Abe.

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Abe, M., Matsumoto, K. Glycated hemoglobin or glycated albumin for assessment of glycemic control in hemodialysis patients with diabetes?. Nat Rev Nephrol 4, 482–483 (2008). https://doi.org/10.1038/ncpneph0881

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  • DOI: https://doi.org/10.1038/ncpneph0881

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