International Urology and Nephrology

, Volume 43, Issue 4, pp 1149–1153

Correlation between glycated hemoglobin and mean plasma glucose in hemodialysis patients

Authors

  • Ezra Israel
    • Department of Internal Medicine, Nephrology DivisionStaten Island University Hospital
    • Department of Internal Medicine, Nephrology DivisionStaten Island University Hospital
  • Omar Maarouf
    • Department of Internal Medicine, Nephrology DivisionStaten Island University Hospital
  • Isabelle Ayoub
    • Department of Internal Medicine, Nephrology DivisionStaten Island University Hospital
  • Jacques Abi Rached
    • Department of Internal Medicine, Nephrology DivisionStaten Island University Hospital
  • Sanaa Rizk
    • Department of Internal Medicine, Nephrology DivisionStaten Island University Hospital
  • Norbert Staynberg
    • Department of Internal Medicine, Nephrology DivisionStaten Island University Hospital
  • Majed Samarneh
    • Department of Internal Medicine, Nephrology DivisionStaten Island University Hospital
  • Suzanne El-Sayegh
    • Department of Internal Medicine, Nephrology DivisionStaten Island University Hospital
Nephrology - Original Paper

DOI: 10.1007/s11255-010-9800-1

Cite this article as:
Israel, E., Geara, A., Maarouf, O. et al. Int Urol Nephrol (2011) 43: 1149. doi:10.1007/s11255-010-9800-1
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Abstract

Background

Since the half-life of red blood cells (RBCs) is shorter in hemodialysis patients, the value of glycated hemoglobin (HbA1c) as a marker of glycemic control in patients with diabetes on hemodialysis has recently been questioned. It is thought that it is not a good marker of mean plasma glucose (MPG) over a 3-month duration. In our current study, we evaluate whether monthly HbA1c values is a better marker of glycemic control than HbA1c every 3 months.

Method

We performed a cross-sectional analysis of a retrospective cohort of 152 patients with diabetes who presented to two hemodialysis units in NYC. Patients had weekly predialysis glucose levels checked over the last 3 months, and HbA1c values were checked every 3 months. Data collection spanned a 6-month time frame from August 2008 to January 2009.

Results

We found no difference in the correlation between HBA1c/mean plasma glucose (MPG) over the last month (MPG1m) and HbA1c/mean plasma glucose (MPG) over the last 3 months (MPG3m; r = 0.57 and r = 0.53, respectively; P = 0.212). Using multivariate analysis, reticulocyte count and weekly erythropoietin dose were found to independently and inversely effect the correlations HbA1c/MPG1m and HbA1c/MPG3m.

Conclusion

The value of HbA1c in hemodialysis for monitoring glycemic control is limited in the setting of a high reticulocyte count (>2%) and a high weekly erythropoietin dose. Checking HbA1c monthly versus every 3 months is not a better approximation of glycemic control in hemodialysis patients.

Keywords

HemodialysisGlycated hemoglobinReticulocyte countMean plasma glucoseDiabetes mellitus

Copyright information

© Springer Science+Business Media, B.V. 2010