title: Lower value of glycated haemoglobin relative to glycaemic control in diabetic patients with end-stage renal disease not on haemodialysis.
abstract: BACKGROUND
  Glycated haemoglobin (HbA1c) concentration is lower relative to glyacemic control in diabetic patients on haemodialysis. However, it is unknown as to whether this is also true for diabetic patients with end-stage renal disease but not on haemodialysis.
  
  
  METHODS
  Correlations between HbA1c or glycated albumin (GA) and estimated glomerular filtration rate (eGFR) (determined by serum creatinine concentration, sex and age) were investigated in 86 diabetic patients with renal dysfunction not on dialysis. The mean values of HbA1c and of red blood cell (RBC) lifespan were compared among four groups of patients: Group 1 (n = 30, eGFR ≥ 60 mL/min/1.73 m(2)), Group 2 (n = 30, eGFR < 60 mL/min/1.73 m(2) but ≥30 mL/min/1.73 m(2)), Group 3 (n = 13, eGFR < 30 mL/min/1.73 m(2) but ≥15 mL/min/1.73 m(2)) and Group 4 (n = 13, eGFR < 15 mL/min/1.73 m(2) without haemodialysis). RBC lifespan was determined in each subject from the difference between alveolar carbon monoxide (CO) concentration and atmospheric CO concentration.
  
  
  RESULTS
  HbA1c was significantly correlated with eGFR (r = 0.37, P = 0.0004), but GA was not. The HbA1c values in Group 3 (6.8 ± 0.6%) and Group 4 (6.3 ± 0.5%) were significantly lower than that in Group 1 (7.4 ± 0.8%), but there was no difference between Group 2 (7.2 ± 0.7%) and Group 1. There was a significant correlation between RBC lifespan and eGFR, and the mean RBC lifespan in Group 3 (96 ± 35 d) and Group 4 (94 ± 30 d) were significantly shorter than that in Group 1 (127 ± 30 d).
  
  
  CONCLUSIONS
  Diabetic patients with stage 4 or 5 chronic kidney disease not on haemodialysis had significantly lower values of HbA1c and shorter RBC lifespan compared with diabetic patients without renal dysfunction.
authors.affiliation: Department of Medicine, Kawashima Hospital, Tokushima 770-8540, Japan. skenji@mb.pikara.ne.jp
authors.forename: Kenji
authors.initials: K
authors.lastname: Shima
authors.forename: Keiko
authors.initials: K
authors.lastname: Chujo
authors.forename: Mayumi
authors.initials: M
authors.lastname: Yamada
authors.forename: Machiko
authors.initials: M
authors.lastname: Komatsu
authors.forename: Yoshihiko
authors.initials: Y
authors.lastname: Noma
authors.forename: Takashi
authors.initials: T
authors.lastname: Mizuguchi
mesh_terms: D000368:Aged; D001786:Blood Glucose / Q000032:analysis; D003404:Creatinine / Q000097:blood; D003924:Diabetes Mellitus, Type 2 / Q000097:blood* / Q000150:complications / Q000503:physiopathology; D004912:Erythrocytes; D005260:Female; D005919:Glomerular Filtration Rate; D006442:Glycated Hemoglobin / Q000032:analysis*; D017127:Glycation End Products, Advanced; D006207:Half-Life; D006801:Humans; D007668:Kidney / Q000378:metabolism* / Q000503:physiopathology; D007676:Kidney Failure, Chronic / Q000097:blood* / Q000150:complications / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D012044:Regression Analysis; D006435:Renal Dialysis; D012709:Serum Albumin / Q000032:analysis; D012720:Severity of Illness Index; D000093423:Glycated Serum Albumin
chemical_list: D001786:Blood Glucose; D003404:Creatinine; D006442:Glycated Hemoglobin; D017127:Glycation End Products, Advanced; D012709:Serum Albumin; D000093423:Glycated Serum Albumin