Serum albumin-adjusted glycated albumin is a better predictor of mortality in diabetic patients with end-stage renal disease on hemodialysis.

Abstract

AIMS:

Glycated albumin (GA) is a marker for monitoring glycemic control in diabetic patients with end-stage renal disease (ESRD). We evaluated whether serum albumin-adjusted GA (adjusted GA) could predict mortality in diabetic patients with ESRD on hemodialysis.

METHODS:

Seventy-eight patients with type 2 diabetes treated with regular hemodialysis were enrolled and followed up for 5-years. The adjusted GA was calculated from the regression formula and mean GA. The cut-off values for GA and adjusted GA that predicted mortality risk were determined using receiver operating characteristic curve analysis.

RESULTS:

During the follow-up period (median: 36months), 15 patients died. In the Kaplan-Meier analysis, there were no significant differences in the 5-year cumulative survival rate (58.3% [GA ≥19.8%] vs. 88.6% [GA <19.8%], P=0.075). Conversely, this rate was significantly higher in patients with adjusted GA <21.2% than adjusted GA ≥21.2% (86.4 vs. 49.5%, P=0.0068). After adjustment for other confounders, adjusted GA ≥21.2% was an independent predictor for mortality (hazard ratio 3.76, 95% confidence interval 1.12-17.44, P=0.031), but GA ≥19.8% was not (hazard ratio 2.63, 95% confidence interval 0.65-17.69, P=0.19).

CONCLUSIONS:

Adjusted GA is a better predictor of mortality than GA in diabetic patients with ESRD on hemodialysis.

• Authors: Takahiro Yajima, Kumiko Yajima, Makoto Hayashi, Keigo Yasuda, Hiroshi Takahashi, Noriyoshi Yamakita
• Journal: Journal of diabetes and its complications (J Diabetes Complications) Vol. 30 Issue 5 Pg. 786-9 (07 2016) ISSN: 1873-460X [Electronic] United States
• PMID: 27009773 (Publication Type: Comparative Study, Journal Article, Observational Study)
• Copyright: Copyright © 2016 Elsevier Inc. All rights reserved.

Chemical References

• Biomarkers
• Glycated Hemoglobin A
• Glycation End Products, Advanced
• Serum Albumin
• hemoglobin A1c protein, human
• Serum Albumin, Human
• Glycated Serum Albumin

Topics

• Aged
• Algorithms
• Biomarkers (blood)
• Diabetes Mellitus, Type 2 (complications, therapy)
• Diabetic Nephropathies (blood, mortality, therapy)
• Female
• Follow-Up Studies
• Glycated Hemoglobin (analysis)
• Glycation End Products, Advanced
• Hospitals, General
• Humans
• Japan (epidemiology)
• Kidney Failure, Chronic (blood, complications, mortality, therapy)
• Male
• Middle Aged
• Mortality
• Outpatient Clinics, Hospital
• Prospective Studies
• ROC Curve
• Renal Dialysis (adverse effects)
• Serum Albumin (analysis)
• Serum Albumin, Human (analysis)
• Survival Analysis
• Glycated Serum Albumin