Impact of elevated serum glycated albumin levels on contrast-induced acute kidney injury in diabetic patients with moderate to severe renal insufficiency undergoing coronary angiography.

Abstract

BACKGROUND:

Glycated albumin (GA) has been shown to be a better indicator than glycosylated hemoglobin A1c (HbA1c) in terms of severity of renal impairment in patients with type 2 diabetes mellitus (T2DM). This study aimed to determine whether elevated serum GA levels are associated with an increased risk for contrast-induced acute kidney injury (CI-AKI) and worse clinical outcome in patients with T2DM and at least moderate renal insufficiency (RI) undergoing coronary angiography.

METHODS:

Serum levels of fasting blood glucose (FBG), HbA1c and GA were measured in 1030 patients with T2DM and moderate to severe RI (eGFR 15-59 mL/min/1.73 m(2)). CI-AKI was defined as ≥ 25% increase in serum creatinine within 72 h after the procedure. Receiver-operating characteristic curve was constructed to assess the predictive value of GA, HbA1c and FBG for CI-AKI. Multivariable logistic regression model was developed to identify risk factors for CI-AKI, and Kaplan-Meier curve analysis was used to compare the rates of dialysis and major adverse cardiac events (MACE) during one-year follow-up.

RESULTS:

The overall rate of CI-AKI was 11.1%. GA was significantly higher in patients with CI-AKI than in those without, and correlated positively with changes of renal function after the procedure. After adjusting for age, sex, left ventricular ejection fraction, multi-vessel disease, type and volume of contrast media, FBG, and HbA1c, GA remained an independent risk factor for CI-AKI. GA ≥ 21% was associated with increased rates of dialysis and MACE during one-year follow-up in patients with or without CI-AKI.

CONCLUSIONS:

Increased GA level serves as a valuable risk factor for CI-AKI and indicates poor one-year clinical outcome in patients with T2DM and moderate to severe RI.

• Authors: Feng Hua Ding, Lin Lu, Rui Yan Zhang, Tian Qi Zhu, Li Jin Pu, Qi Zhang, Qiu Jing Chen, Jian Hu, Zhen Kun Yang, Wei Feng Shen
• Journal: International journal of cardiology (Int J Cardiol) Vol. 167 Issue 2 Pg. 369-73 (Jul 31 2013) ISSN: 1874-1754 [Electronic] Netherlands
• PMID: 22244477 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)
• Copyright: Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.

Chemical References

• Biomarkers
• Contrast Media
• Glycation End Products, Advanced
• Serum Albumin
• Glycated Serum Albumin

Topics

• Acute Kidney Injury (blood, chemically induced, diagnostic imaging)
• Aged
• Aged, 80 and over
• Biomarkers (blood)
• Contrast Media (adverse effects)
• Coronary Angiography (adverse effects)
• Diabetes Mellitus, Type 2 (blood, diagnostic imaging)
• Female
• Follow-Up Studies
• Glycation End Products, Advanced
• Humans
• Male
• Middle Aged
• Prospective Studies
• Renal Insufficiency (blood, diagnostic imaging)
• Retrospective Studies
• Risk Factors
• Serum Albumin (metabolism)
• Severity of Illness Index
• Glycated Serum Albumin