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.
This is a preview of subscription content, access via your institution
Relevant articles
Open Access articles citing this article.
-
Diabetes-related knowledge in diabetic haemodialysis patients: a cross-sectional study from Palestine
Renal Replacement Therapy Open Access 27 November 2019
-
Glycemic control and survival in peritoneal dialysis patients with diabetes: A 2-year nationwide cohort study
Scientific Reports Open Access 01 March 2019
Access options
Subscribe to this journal
Receive 12 print issues and online access
$209.00 per year
only $17.42 per issue
Buy this article
- Purchase on Springer Link
- Instant access to full article PDF
Prices may be subject to local taxes which are calculated during checkout
References
Gaede P et al. (2003) Multifactorial intervention and cardiovascular disease in patients with type 2 diabetes. N Engl J Med 348: 383–393
Morioka T et al. (2001) Glycemic control is a predictor of survival for diabetic patients on hemodialysis. Diabetes Care 24: 909–913
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
Joy MS et al. (2002) Long-term glycemic control measurements in diabetic patients receiving hemodialysis. Am J Kidney Dis 39: 297–307
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
Peacock TP et al. (2008) Comparison of glycated albumin and hemoglobin A1c levels in diabetic subjects on hemodialysis. Kidney Int 73: 1062–1068
Author information
Authors and Affiliations
Corresponding author
Ethics declarations
Competing interests
The authors declare no competing financial interests.
Rights and permissions
About this article
Cite this article
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
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1038/ncpneph0881
This article is cited by
-
Diabetes-related knowledge in diabetic haemodialysis patients: a cross-sectional study from Palestine
Renal Replacement Therapy (2019)
-
Glycemic control and survival in peritoneal dialysis patients with diabetes: A 2-year nationwide cohort study
Scientific Reports (2019)
-
Haemodialysis-induced hypoglycaemia and glycaemic disarrays
Nature Reviews Nephrology (2015)
-
Cycling of hemoglobin A1c associated with hemoglobin cycling in diabetic patients under hemodialysis and its theoretical simulation
Diabetology International (2015)
-
Glucose management in diabetic patients undergoing hemodialysis
Diabetology International (2014)