Relationship between assays of glycemia in diabetic subjects with advanced chronic kidney disease
Abstract
Background Relative to hemoglobin A(1c) (HbA(1c)), glycated albumin (GA) more accurately reflects recent glycemic control in diabetic patients on hemodialysis and peritoneal dialysis. These assays have yet to be compared in patients with advanced chronic kidney disease (CKD). Methods HbA(1c) and GA were simultaneously measured in 303 diabetic subjects: 70 with CKD prior to dialysis (CKD-stage 4), 184 with CKD after transplantation (TXP-stage 3) and 49 non-nephropathy controls. Results Mean estimated GFR was 76, 46 and 26 ml/min in controls, TXP-3 and CKD-4 cases, respectively. Mean (SD) HbA(1c) (%) and GA (%) concentrations were 7.30 (1.40) and 16.8 (4.9) in controls, 7.28 (1.66) and 21.5 (6.4) in CKD-4 cases, and 7.21 (1.62) and 21.2 (5.5) in TXP-3 cases, respectively. The GA:HbA(1c) ratio differed significantly between non-nephropathy controls and both groups of CKD patients (both p Conclusions The relationship between glycated albumin and HbA(1c) is influenced by the presence of reduced GFR in diabetic patients with CKD. The accuracy of the HbA(1c) assay in diabetic subjects with severe nephropathy requires further investigation, although HbA(1c) performs relatively well with milder CKD.
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In observational studies, glycated albumin is associated with all-cause and cardiovascular mortality in patients treated by chronic hemodialysis.
“In observational studies, glycated albumin is associated with all-cause and cardiovascular mortality in patients treated by chronic hemodialysis.”
From KDIGO 2022 Clinical Practice Guideline for Diabetes Management in Chronic Kidney Disease (2022) · cites this paper as [196]
Correlations of fructosamine with HbA1c and mean blood glucose were examined in 4 observational studies.
“Correlations of fructosamine with HbA1c and mean blood glucose were examined in 4 observational studies.”
From KDIGO 2022 Clinical Practice Guideline for Diabetes Management in Chronic Kidney Disease (2022) · cites this paper as [196]
Accuracy and precision of HbA1c measurement declines with advanced CKD (G4-G5), particularly among patients treated by dialysis, in whom HbA1c measurements have low reliability.
“Practice Point 2.1.2: Accuracy and precision of HbA1c measurement declines with advanced CKD (G4 -G5), particularly among patients treated by dialysis, in whom HbA1c measurements have low reliability.”
From KDIGO 2022 Clinical Practice Guideline for Diabetes Management in Chronic Kidney Disease (2022) · cites this paper as [196]
Correlations of directly measured blood glucose levels with HbA1c, glycated albumin, and fructosamine were progressively weaker with advanced CKD stages (G4-G5), especially kidney failure treated by dialysis.
“Correlations of directly measured blood glucose levels with 3 glycemic biomarkers -HbA1c, glycated albumin, and fructosamine -were progressively weaker with advanced CKD stages (G4 -G5), especially kidney failure treated by dialysis. 196,197,205,210,227”
From KDIGO 2022 Clinical Practice Guideline for Diabetes Management in Chronic Kidney Disease (2022) · cites this paper as [196]
Cites
Comparison of glycated albumin and hemoglobin A1c levels in diabetic subjects on hemodialysis
Peacock, T. P., Shihabi, Z. K., Bleyer, A. J., Dolbare, E. L., Byers, J. R., Knovich, M. A., Calles-Escandon, J., Russell, G. B., & Freedman, B. I. (2008) · Kidney International · doi:10.1038/ki.2008.25 · Cited by 323 · see citing works
Self-citationFreedman, B. I., Shenoy, R. N., Planer, J. A., Clay, K. D., Shihabi, Z. K., Burkart, J. M., Cardona, C. Y., Andries, L., Peacock, T. P., Sabio, H., et al. (2010) · Peritoneal Dialysis International: Journal of the International Society for Peritoneal Dialysis · doi:10.3747/pdi.2008.00243 · Cited by 121 · see citing works
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KDIGO 2020 Clinical practice guideline for diabetes management in chronic kidney disease
de Boer, I. H., Caramori, M. L., Chan, J. C. N., Heerspink, H. J. L., Hurst, C., Khunti, K., Liew, A., Michos, E. D., Navaneethan, S. D., Olowu, W. A., et al. (2020) · Kidney International · doi:10.1016/j.kint.2020.06.019 · Cited by 1,399 · see citing works
KDOQI clinical practice guideline for diabetes and CKD: 2012 update
(2012) · American Journal of Kidney Diseases · doi:10.1053/j.ajkd.2012.07.005 · Cited by 1,320 · see citing works
KDIGO 2022 Clinical Practice Guideline for Diabetes Management in Chronic Kidney Disease
Rossing, P., Caramori, M. L., Chan, J. C. N., Heerspink, H. J. L., Hurst, C., Khunti, K., Liew, A., Michos, E. D., Navaneethan, S. D., Olowu, W. A., et al. (2022) · Kidney International · doi:10.1016/j.kint.2022.06.008 · Cited by 1,373 · see citing works
Influence of proteinuria on glycated albumin values in diabetic patients with chronic kidney disease
Okada, T., Nakao, T., Matsumoto, H., Nagaoka, Y., Tomaru, R., Iwasawa, H., & Wada, T. (2011) · Internal Medicine · doi:10.2169/internalmedicine.50.4129 · Cited by 81 · see citing works
Glycated hemoglobin and outcomes in patients with advanced diabetic chronic kidney disease
Kuo, I.-C., Lin, H. Y.-H., Niu, S.-W., Hwang, D.-Y., Lee, J.-J., Tsai, J.-C., Hung, C.-C., Hwang, S.-J., & Chen, H.-C. (2016) · Scientific Reports · doi:10.1038/srep20028 · Cited by 70 · see citing works
Zelnick, L. R., Batacchi, Z. O., Ahmad, I., Dighe, A., Little, R. R., Trence, D. L., Hirsch, I. B., & de Boer, I. H. (2020) · Diabetes Care · doi:10.2337/dc20-0915 · Cited by 55 · see citing works
- Authors
- Freedman, B. I., Shihabi, Z. K., Andries, L., Cardona, C. Y., Peacock, T. P., Byers, J. R., Russell, G. B., Stratta, R. J., & Bleyer, A. J.
- Affiliations
- Wake Forest University Health Sciences (US)
- Venue
- American Journal of Nephrology
- Publisher
- S. Karger AG
- Published
- 2010
- Volume
- 31
- Issue
- 5
- Pages
- 375-379
- ISSN
- 0250-8095 (ISSN-L)
- 1421-9670
- OpenAlex
- W1975180120
- Cited by
- 90
- References
- 2
- Citations by year
- 2026: 3 · 2024: 6 · 2023: 4 · 2022: 3 · 2021: 3 · 2020: 9 · 2019: 3 · 2018: 7 · 2017: 7 · 2016: 10 · 2015: 8 · 2014: 6 · 2013: 3 · 2012: 8
- FWCI
- 5.23
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- American Journal of Nephrology (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Nephrology › Chronic Kidney Disease and Diabetes
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Research
- Health Sciences › Medicine › Nephrology › Dialysis and Renal Disease Management
- Keywords
- glycated albumin, HbA1c, glycemic control, diabetic nephropathy, advanced chronic kidney disease, estimated glomerular filtration rate, dialysis, kidney transplantation, glycemic markers
- MeSH terms
- Glycated Serum Albumin, Aged, Diabetes Mellitus, Female, Glomerular Filtration Rate, Glycated Hemoglobin, Humans, Hyperglycemia, Hypoglycemic Agents, Kidney Failure, Chronic, Male, Middle Aged, Models, Biological, Serum Albumin, Kidney Transplantation, Glycation End Products, Advanced, Diabetes Complications
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