The use of predialysis glucose as long term glycemic marker in hemodialysis patients

Aim: The major cause of chronic renal disease (CRD) is diabetes mellitus (DM). Although there are some other long term glycemic markers available, HbA1c remains the gold standart in CRD. In this study we aimed to explore the relation between average predialysis glucose and HbA1c levels. Material and Method: 101 diabetic hemodialysis patients from two centers were included in this study. Last 2 and 3 months’ average predialysis glucose levels were obtained. After 3 months, HbA1c levels were also studied. Results: A significant and strong correlation between HbA1c and both 2 and 3 months’ average predialysis glucose levels were found (p

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  • Hill NR, Fatoba ST, Oke JL, et al. Global prevalence of chronic kidney disease - a systematic review and meta-analysis. PLoS One 2016; 11: e0158765.
  • Levey AS, Coresh J. Chronic kidney disease. Lancet 2012; 379: 165-80
  • Tuttle KR, Bakris GL, Bilous RW, et al. Diabetic kidney disease: a report from an ADA Consensus Conference. Am J Kidney Dis 2014; 64: 510-33.
  • United States Renal Data System 2021 USRDS Annual Data Report: Epidemiology of kidney disease in the United States. National Institutes of Health, National Institute of Diabetes and Digestive and Kidney Diseases, Bethesda, MD, 2021.
  • Mehdi U, Toto RD. Anemia, diabetes, and chronic kidney disease. Diabetes Care 2009; 32: 1320-6.
  • Consensus Committee. Consensus statement on the worldwide standardization of the hemoglobin A1C measurement: the American Diabetes Association, European Association for the Study of Diabetes, International Federation of Clinical Chemistry and Laboratory Medicine, and the International Diabetes Federation. Diabetes Care 2007; 30: 2399-400.
  • Gomez-Peralta F, Choudhary P, Cosson E, Irace C, Rami-Merhar B, Seibold A. Understanding the clinical implications of differences between GMI and HbA1c. Diabetes Obes Metab 2022. doi: 10.1111/dom.14638.
  • Gallagher EJ, Le Roith D, Bloomgarden Z. Review of hemoglobin A(1c) in the management of diabetes. J Diabetes 2009; 1: 9-17.
  • Copur S, Onal EM, Afsar B, et al. Diabetes mellitus in chronic kidney disease: Biomarkers beyond HbA1c to estimate glycemic control and diabetes-dependent morbidity and mortality. J Diabetes Complications 2020; 34: 107707
  • Selvaraj N, Bobby Z, Sridhar MG. Increased glycation of hemoglobin in chronic renal failure: [corrected] potential role of oxidative stress. Arch Med Res 2008; 39: 277-84.
  • Speeckaert M, Van Biesen W, Delanghe J, et al; European Renal Best Practice Guideline Development Group on Diabetes in Advanced CKD. Are there better alternatives than haemoglobin A1c to estimate glycaemic control in the chronic kidney disease population? Nephrol Dial Transplant 2014; 29: 2167-77.
  • American Diabetes Association Professional Practice Committee; , Draznin B, Aroda VR, Bakris G, et al. 6. Glycemic Targets: Standards of Medical Care in Diabetes-2022. Diabetes Care 2022; 45: S83-S96.
  • Kidney Disease: Improving Global Outcomes (KDIGO) Diabetes Work Group. KDIGO 2020 Clinical Practice Guideline for Diabetes Management in Chronic Kidney Disease. Kidney Int 2020; 98: S1-S115.
  • Jung M, Warren B, Grams M, et al. Performance of non-traditional hyperglycemia biomarkers by chronic kidney disease status in older adults with diabetes: results from the atherosclerosis risk in communities study. J Diabetes 2018; 10: 276-85.
  • Nathan DM, Kuenen J, Borg R, Zheng H, Schoenfeld D, Heine RJ. A1c-Derived Average Glucose Study Group. Translating the A1C assay into estimated average glucose values. Diabetes Care 2008; 31: 1473-8.
  • Bomholt T, Adrian T, Nørgaard K, et al. The use of HbA1c, glycated albumin and continuous glucose monitoring to assess glucose control in the chronic kidney disease population including dialysis. Nephron 2021; 145: 14-9.
  • Sayed M, Adnan F, Majeed M. Is HbA1c a true marker of glycaemic control in diabetic patients on haemodialysis? J Ayub Med Coll Abbottabad 2019; 31: 46-50.
  • George C, Matsha TE, Korf M, Zemlin AE, Erasmus RT, Kengne AP. The agreement between fasting glucose and markers of chronic glycaemic exposure in individuals with and without chronic kidney disease: a cross-sectional study. BMC Nephrol 2020; 21: 32.
  • Wang F, Wang D, Lyu XL, Sun XM, Duan BH. Continuous glucose monitoring in diabetes patients with chronic kidney disease on dialysis: a meta-analysis. Minerva Endocrinol 2020 Dec 3.
  • Hayashi A, Takano K, Masaki T, Yoshino S, Ogawa A, Shichiri M. Distinct biomarker roles for HbA1c and glycated albumin in patients with type 2 diabetes on hemodialysis. J Diabetes Complications 2016; 30: 1494-9.
  • Watanabe Y, Ohno Y, Inoue T, Takane H, Okada H, Suzuki H. Blood glucose levels in peritoneal dialysis are better reflected by HbA1c than by glycated albumin. Adv Perit Dial 2014; 30: 75-82.
  • Presswala L, Hong S, Harris Y, et al. Continuous glucose monitoring and glycemic control in patients with type 2 diabetes mellitus and CKD. Kidney Med 2019; 1: 281-7.
  • Williams ME, Mittman N, Ma L, et al. The glycemic indices in dialysis evaluation (GIDE) study: comparative measures of glycemic control in diabetic dialysis patients. Hemodial Int 2015; 19: 562-71.