Poor Glycemic Control Raises CV Risks in Diabetic Dialysis Patients
ATLANTA—Poor glycemic control in incident dialysis patients is associated with an increased risk of cardiovascular death or non-fatal major cardiovascular (CV) events in patients with diabetes mellitus, according to a South Korean study presented at the American Society of Nephrology's Kidney Week 2013 meeting.
In a prospective cohort, Mi Jung Lee, MD, and collaborators from Yonsei University in Seoul examined 907 incident dialysis patients with type 1 or 2 diabetes mellitus. The investigators gathered patient information from 36 dialysis centers of the Clinical Research Center for ESRD throughout South Korea. They categorized patients by hemoglobin A1C levels. The mean baseline A1C was 6.6% and the mean follow-up duration was 15 months.
Compared with patients who had an A1C of 7.0% to 7.9%, those with an A1c below 6.0% had a 59% increased risk of a composite outcome of CV death or non-fatal major CV events. Subjects with an A1c of 6.0%-6.9%, 8.0%-8.9%, and 9.0% or greater had a twofold increased risk.
The researchers determined that an A1C of 9.0% or greater was significantly associated with an increased risk of CV events in patients with a body mass index of 24 kg/m2 or greater and a serum albumin level of 3.3 g/dL or greater.
Thirty-nine patients died from CV complications and 78 experienced non-fatal CV events.