Glycated hemoglobin predicts mortality in nondiabetic patients receiving chronic peritoneal dialysis.
BACKGROUND
patients with chronic peritoneal dialysis (CPD) use glucose-based dialysate to maintain their life; however, whether the glycemic status influences outcome of these patients without diabetes remains unknown.


METHODS
we conducted a cross-sectional and 18-month prospective study, and 269 nondiabetic patients with CPD were enrolled in a medical center. Glycated hemoglobin (HbA1c) levels were measured at baseline and categorized in tertiles of HbA1c: high (>5.4%), middle (5.1-5.4%) and low normal (<5.1%). Mortality and cause of death were recorded for longitudinal analyses.


RESULTS
the study results showed high HbA1c group patients had a trend of being older and having higher body mass index (BMI) than other group patients. Stepwise multiple linear regression analysis showed HbA1c was positively related to age, BMI and the peritoneal solute transport rate. After 18 months of follow-up, Cox multivariate analysis showed that HbA1c (HR: 4.114; 95% CI: 1.426-11.872; p = 0.009) was the significant risk factor for all-cause mortality after relating variables were adjusted. Moreover, high HbA1c (HR: 3.892; 95% CI: 1.273-11.959; p = 0.026) and low HbA1c (HR: 1.179; 95% CI: 1.160-1.198; p = 0.039), with middle HbA1c group as the reference, also significantly predicted for mortality in these patients.


CONCLUSIONS
HbA1c levels, or presence of low or high HbA1c, are associated with 18-month all-cause mortality in nondiabetic patients with CPD.
Department of Nephrology and Division of Clinical Toxicology, Chang Gung Memorial Hospital, Lin-Kou Medical Center, Taipei, Taiwan, ROC.
Kuan-Hsing
KH
Chen
Ja-Liang
JL
Lin
Dan-Tzu
DT
Lin-Tan
Ching-Wei
CW
Hsu
Wen-Hung
WH
Huang
Tzung-Hai
TH
Yen
Shu-Man
SM
Weng
Cheng-Chieh
CC
Hung
D000328:Adult; D000367:Age Factors; D015992:Body Mass Index; D003430:Cross-Sectional Studies; D015314:Dialysis Solutions; D005260:Female; D006442:Glycated Hemoglobin / Q000378:metabolism*; D006801:Humans; D016014:Linear Models; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D009026:Mortality; D010530:Peritoneal Dialysis; D016016:Proportional Hazards Models; D011446:Prospective Studies; D012307:Risk Factors
D015314:Dialysis Solutions; D006442:Glycated Hemoglobin