title: Serum albumin-adjusted glycated albumin is a better predictor of mortality in diabetic patients with end-stage renal disease on hemodialysis.
abstract: Glycated albumin (GA) is a marker for monitoring glycemic control in diabetic patients with end-stage renal disease (ESRD). We evaluated whether serum albumin-adjusted GA (adjusted GA) could predict mortality in diabetic patients with ESRD on hemodialysis.
  
  
  
  Seventy-eight patients with type 2 diabetes treated with regular hemodialysis were enrolled and followed up for 5-years. The adjusted GA was calculated from the regression formula and mean GA. The cut-off values for GA and adjusted GA that predicted mortality risk were determined using receiver operating characteristic curve analysis.
  
  
  
  During the follow-up period (median: 36months), 15 patients died. In the Kaplan-Meier analysis, there were no significant differences in the 5-year cumulative survival rate (58.3% [GA ≥19.8%] vs. 88.6% [GA <19.8%], P=0.075). Conversely, this rate was significantly higher in patients with adjusted GA <21.2% than adjusted GA ≥21.2% (86.4 vs. 49.5%, P=0.0068). After adjustment for other confounders, adjusted GA ≥21.2% was an independent predictor for mortality (hazard ratio 3.76, 95% confidence interval 1.12-17.44, P=0.031), but GA ≥19.8% was not (hazard ratio 2.63, 95% confidence interval 0.65-17.69, P=0.19).
  
  
  
  Adjusted GA is a better predictor of mortality than GA in diabetic patients with ESRD on hemodialysis.
authors.affiliation: Department of Nephrology, Matsunami General Hospital, Gifu 501-6062, Japan. Electronic address: yajima5639@gmail.com.
authors.forename: Takahiro
authors.initials: T
authors.lastname: Yajima
authors.affiliation: Department of Internal Medicine, Matsunami General Hospital, Gifu 501-6062, Japan.
authors.forename: Kumiko
authors.initials: K
authors.lastname: Yajima
authors.affiliation: Department of Internal Medicine, Matsunami General Hospital, Gifu 501-6062, Japan.
authors.forename: Makoto
authors.initials: M
authors.lastname: Hayashi
authors.affiliation: Department of Internal Medicine, Matsunami General Hospital, Gifu 501-6062, Japan.
authors.forename: Keigo
authors.initials: K
authors.lastname: Yasuda
authors.affiliation: Division of Medical Statistics, Fujita Health University School of Medicine, Aichi 470-1192, Japan.
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Takahashi
authors.affiliation: Department of Internal Medicine, Matsunami General Hospital, Gifu 501-6062, Japan.
authors.forename: Noriyoshi
authors.initials: N
authors.lastname: Yamakita
mesh_terms: D000368:Aged; D000465:Algorithms; D015415:Biomarkers / Q000097:blood; D003924:Diabetes Mellitus, Type 2 / Q000150:complications* / Q000628:therapy; D003928:Diabetic Nephropathies / Q000097:blood / Q000401:mortality / Q000628:therapy*; D005260:Female; D005500:Follow-Up Studies; D006442:Glycated Hemoglobin / Q000032:analysis; D017127:Glycation End Products, Advanced; D006769:Hospitals, General; D006801:Humans; D007564:Japan / Q000453:epidemiology; D007676:Kidney Failure, Chronic / Q000097:blood / Q000150:complications / Q000401:mortality / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D009026:Mortality; D010044:Outpatient Clinics, Hospital; D011446:Prospective Studies; D012372:ROC Curve; D006435:Renal Dialysis / Q000009:adverse effects*; D012709:Serum Albumin / Q000032:analysis*; D000075462:Serum Albumin, Human / Q000032:analysis*; D016019:Survival Analysis; D000093423:Glycated Serum Albumin
chemical_list: D015415:Biomarkers; D006442:Glycated Hemoglobin; D017127:Glycation End Products, Advanced; D012709:Serum Albumin; D000075462:Serum Albumin, Human; D000093423:Glycated Serum Albumin; C517652:hemoglobin A1c protein, human
keywords: Adjusted GA; ESRD; GA; Hemodialysis; Type 2 diabetes