title: Relationship between the accuracy of glycemic markers and the chronic kidney disease stage in patients with type 2 diabetes mellitus.
abstract: BACKGROUND
  It is important to establish glycemic markers which reflect accurate glycemic status in advanced chronic kidney disease (CKD) patients; however, adequate glycemic markers have not been established. We evaluated the accuracy of glycemic markers in non-dialysis CKD patients.
  
  
  METHODS
  139 non-dialysis CKD patients with diabetes were enrolled. The patients were divided into three groups as follows: group 1 (G1), patients with an estimated glomerular filtration rate (eGFR) >= 60 mL/min/1.73 m2; group 2 (G2), 30 ≤ eGFR < 60; and group 3 (G3), eGFR < 30. The patients were also classified by serum albumin: patients with serum albumin >= 3.5 g/dL as group S1 (S1) and serum albumin < 3.5 as group S2 (S2).
  
  
  RESULTS
  Glycated hemoglobin (A1C) was positively correlated with random PG in G1 and G2; however, no significant correlation was observed in G3. Whereas glycated albumin (GA) was correlated with random PG in S1, there was no significant correlation in S2. To clarify the significance of A1C and GA, the relationships among A1C, GA, and various clinical parameters were examined. GA was correlated with serum albumin and the urinary albumin-creatinine ratio, whereas A1C was significantly correlated with hemoglobin, the dose of recombinant human erythropoietin, and eGFR.
  
  
  CONCLUSIONS
  A1C was affected by eGFR, and GA was influenced by hypoalbuminemia; therefore, it is necessary to choose adequate glycemic markers according to the CKD stage and serum albumin level. GA is a superior glycemic marker in patients with eGFR < 30 mL/min/1.73 m2 and serum albumin >= 3.5 g/dL.
authors.forename: Koji
authors.initials: K
authors.lastname: Harada
authors.forename: Koichi
authors.initials: K
authors.lastname: Sumida
authors.forename: Yukinari
authors.initials: Y
authors.lastname: Yamaguchi
authors.forename: Yasuhiro
authors.initials: Y
authors.lastname: Akai
mesh_terms: D000368:Aged; D000419:Albuminuria / Q000175:diagnosis; D015415:Biomarkers / Q000097:blood / Q000652:urine; D001786:Blood Glucose / Q000032:analysis; D003404:Creatinine / Q000652:urine; D003924:Diabetes Mellitus, Type 2 / Q000097:blood*; D003928:Diabetic Nephropathies / Q000097:blood*; D005260:Female; D005919:Glomerular Filtration Rate; D006442:Glycated Hemoglobin / Q000032:analysis; D017127:Glycation End Products, Advanced; D006801:Humans; D008297:Male; D051436:Renal Insufficiency, Chronic / Q000097:blood*; D012709:Serum Albumin / Q000032:analysis; D000093423:Glycated Serum Albumin
chemical_list: D015415:Biomarkers; D001786:Blood Glucose; D003404:Creatinine; D006442:Glycated Hemoglobin; D017127:Glycation End Products, Advanced; D012709:Serum Albumin; D000093423:Glycated Serum Albumin; C517652:hemoglobin A1c protein, human