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Target for glycemic control in type 2 diabetic patients on hemodialysis: effects of anemia and erythropoietin injection on hemoglobin A(1c).
Ther Apher Dial. 2009 Apr; 13(2):89-94.TA

Abstract

In hemodialysis (HD) patients the glycated hemoglobin (Hb(A1c)) level may underestimate glycemic control. The aim of this study is to estimate accurate glycemic control in type 2 diabetic patients on HD. Type 2 diabetes patients (N = 87) who had been receiving maintenance HD for at least one year were enrolled. Hb(A1c) and the percentage of glycated albumin relative to total the serum albumin (%GA) were measured in blood samples and the factors that affected the %GA/Hb(A1c) ratio were examined. There were significant and positive correlations between the plasma glucose and either the Hb(A1c) levels (r = 0.539, P < 0.01) or the %GA level (r = 0.520, P < 0.01). No relationship between the serum albumin levels and %GA levels was observed. A weekly dose of erythropoietin (EPO) was positively correlated with the ratio of %GA/Hb(A1c) and hematocrit (Ht) correlated negatively. There was no significant correlation between the %GA/Hb(A1c) level and the EPO dose in patients with Ht > or = 30%, although a significant correlation was found between those parameters in the Ht < 30% group. The mean of the %GA/Hb(A1c) ratios in patients with Ht > or = 30%, with Ht < 30% and treated with EPO < 100 IU/kg/week, and with Ht < 30% and treated with EPO > or = 100 IU/kg/week were 3.41, 3.56 and 4.13, respectively. In HD patients, accurate glycemic control may be estimated as: Hb(A1c) x 1.14 if Ht > or = 30%; Hb(A1c) x 1.19 if Ht < 30% and treated with low dosages of EPO; and Hb(A1c) x 1.38 if Ht < 30% and treated with high dosages of EPO.

Authors+Show Affiliations

Department of Medicine, Shiga University of Medical Science, Shiga, Japan. takuzu@belle.shiga-med.ac.jpNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

19379146

Citation

Uzu, Takashi, et al. "Target for Glycemic Control in Type 2 Diabetic Patients On Hemodialysis: Effects of Anemia and Erythropoietin Injection On Hemoglobin A(1c)." Therapeutic Apheresis and Dialysis : Official Peer-reviewed Journal of the International Society for Apheresis, the Japanese Society for Apheresis, the Japanese Society for Dialysis Therapy, vol. 13, no. 2, 2009, pp. 89-94.
Uzu T, Hatta T, Deji N, et al. Target for glycemic control in type 2 diabetic patients on hemodialysis: effects of anemia and erythropoietin injection on hemoglobin A(1c). Ther Apher Dial. 2009;13(2):89-94.
Uzu, T., Hatta, T., Deji, N., Izumiya, T., Ueda, H., Miyazawa, I., Kanasaki, M., Isshiki, K., Nishio, T., & Arimura, T. (2009). Target for glycemic control in type 2 diabetic patients on hemodialysis: effects of anemia and erythropoietin injection on hemoglobin A(1c). Therapeutic Apheresis and Dialysis : Official Peer-reviewed Journal of the International Society for Apheresis, the Japanese Society for Apheresis, the Japanese Society for Dialysis Therapy, 13(2), 89-94. https://doi.org/10.1111/j.1744-9987.2009.00661.x
Uzu T, et al. Target for Glycemic Control in Type 2 Diabetic Patients On Hemodialysis: Effects of Anemia and Erythropoietin Injection On Hemoglobin A(1c). Ther Apher Dial. 2009;13(2):89-94. PubMed PMID: 19379146.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Target for glycemic control in type 2 diabetic patients on hemodialysis: effects of anemia and erythropoietin injection on hemoglobin A(1c). AU - Uzu,Takashi, AU - Hatta,Tsuguru, AU - Deji,Naoko, AU - Izumiya,Tamani, AU - Ueda,Hisami, AU - Miyazawa,Itsuko, AU - Kanasaki,Masami, AU - Isshiki,Keiji, AU - Nishio,Toshiji, AU - Arimura,Tetsuro, PY - 2009/4/22/entrez PY - 2009/4/22/pubmed PY - 2009/7/17/medline SP - 89 EP - 94 JF - Therapeutic apheresis and dialysis : official peer-reviewed journal of the International Society for Apheresis, the Japanese Society for Apheresis, the Japanese Society for Dialysis Therapy JO - Ther Apher Dial VL - 13 IS - 2 N2 - In hemodialysis (HD) patients the glycated hemoglobin (Hb(A1c)) level may underestimate glycemic control. The aim of this study is to estimate accurate glycemic control in type 2 diabetic patients on HD. Type 2 diabetes patients (N = 87) who had been receiving maintenance HD for at least one year were enrolled. Hb(A1c) and the percentage of glycated albumin relative to total the serum albumin (%GA) were measured in blood samples and the factors that affected the %GA/Hb(A1c) ratio were examined. There were significant and positive correlations between the plasma glucose and either the Hb(A1c) levels (r = 0.539, P < 0.01) or the %GA level (r = 0.520, P < 0.01). No relationship between the serum albumin levels and %GA levels was observed. A weekly dose of erythropoietin (EPO) was positively correlated with the ratio of %GA/Hb(A1c) and hematocrit (Ht) correlated negatively. There was no significant correlation between the %GA/Hb(A1c) level and the EPO dose in patients with Ht > or = 30%, although a significant correlation was found between those parameters in the Ht < 30% group. The mean of the %GA/Hb(A1c) ratios in patients with Ht > or = 30%, with Ht < 30% and treated with EPO < 100 IU/kg/week, and with Ht < 30% and treated with EPO > or = 100 IU/kg/week were 3.41, 3.56 and 4.13, respectively. In HD patients, accurate glycemic control may be estimated as: Hb(A1c) x 1.14 if Ht > or = 30%; Hb(A1c) x 1.19 if Ht < 30% and treated with low dosages of EPO; and Hb(A1c) x 1.38 if Ht < 30% and treated with high dosages of EPO. SN - 1744-9987 UR - https://www.unboundmedicine.com/medline/citation/19379146/Target_for_glycemic_control_in_type_2_diabetic_patients_on_hemodialysis:_effects_of_anemia_and_erythropoietin_injection_on_hemoglobin_A_1c__ L2 - https://doi.org/10.1111/j.1744-9987.2009.00661.x DB - PRIME DP - Unbound Medicine ER -