Poor glycemic control prior to initiating hemodialysis is associated with worse survival in diabetic patients, according to researchers in Japan.


Investigators at Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences and Shigei Medical Research Hospital in Okayama studied 98 patients with end-stage renal disease (ESRD) related to diabetic nephropathy (66 men and 32 women; mean age 68.2 years). The two groups had different glycated albumin (GA) and HbA1c levels but otherwise had similar clinical characteristics. Subjects had a mean follow-up period of 47.7 months.

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The researchers categorized subjects into two group based on glycated albumin (GA) levels: a low-GA group (less than 29%; 54 patients) and a high-GA group (29% or higher; 44 patients).


The authors noted that GA is a reliable marker for monitoring glycemic control, especially in ESRD patients.


After adjusting for age, gender, total cholesterol, C-reactive protein, and albumin, the high-GA group had a significantly higher mortality risk than the low-GA group, the investigators reported in Nephrology (2007; published online ahead of print). Each 1% increment in GA was associated with a 4.2% increased risk of death. In addition, the high-GA group was at threefold higher risk of cardiovascular death than the low-GA group.