title: HbA1c and survival in maintenance hemodialysis patients with diabetes in Han Chinese population.
abstract: BACKGROUND
  Previous observational studies using differing methodologies have yielded inconsistent results regarding the association between glycemic control and outcomes in diabetic patients receiving maintenance hemodialysis (MHD). The aim of this study was to investigate the association between HbA1c and survival in diabetic MHD patients in Han Chinese population.
  
  
  METHODS
  A 5-year cohort (October 2007-December 2013) of 236 diabetic MHD patients with HbA1c data was examined for associations between HbA1c and mortality. Death hazard ratios (HR) were estimated using Cox regressions.
  
  
  RESULTS
  Two hundred and thirty-six diabetes patients undergoing MHD in clinics over 5 years were included in our study. Unadjusted survival analyses indicated paradoxically lower death HRs with higher HbA1c values. However, after adjusting for potential confounders (demographics, dialysis vintage, comorbidity, anemia, and inflammation), higher HbA1c values were incrementally associated with higher death risks.
  
  
  CONCLUSIONS
  Poor glycemic control (HbA1c ≥ 8 %) appears to be associated with decreased survival in the general population of diabetic MHD patients. Our study suggests that moderate hyperglycemia increases the risk for all-cause mortality of diabetic MHD patients in Han Chinese population.
authors: Department of Blood Purification Center, The Third Affiliated Hospital of Soochow University, Changzhou, 213003, People's Republic of China, lxr230@126.com.
authors: Xiurong
authors: X
authors: Li
authors: Xianlin
authors: X
authors: Xu
authors: Jinfeng
authors: J
authors: Liu
authors: Junwei
authors: J
authors: Yang
authors: Li
authors: L
authors: Fang
authors: Liying
authors: L
authors: Miao
authors: Jia
authors: J
authors: Di
authors: Xiaozhou
authors: X
authors: He
mesh_terms: D015415:Biomarkers / Q000097:blood; D002681:China / Q000453:epidemiology; D003924:Diabetes Mellitus, Type 2 / Q000097:blood* / Q000150:complications / Q000208:ethnology; D005006:Ethnicity; D005260:Female; D005500:Follow-Up Studies; D006442:Glycated Hemoglobin / Q000378:metabolism*; D006801:Humans; D007676:Kidney Failure, Chronic / Q000209:etiology / Q000401:mortality* / Q000628:therapy; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D016016:Proportional Hazards Models; D006435:Renal Dialysis; D012189:Retrospective Studies; D015996:Survival Rate / Q000639:trends; D013997:Time Factors
chemical_list: D015415:Biomarkers; D006442:Glycated Hemoglobin; C517652:hemoglobin A1c protein, human