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HbA1c and survival in maintenance hemodialysis patients with diabetes in Han Chinese population

International Urology and Nephrology volume 46, pages 2207–2214 (2014)Cite this article

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.

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Affiliations

  1. Department of Blood Purification Center, The Third Affiliated Hospital of Soochow University, Changzhou, 213003, People’s Republic of China

    Xiurong Li, Xianlin Xu, Jinfeng Liu, Liying Miao, Jia Di & Xiaozhou He

  2. Center of Kidney Disease, 2nd Affiliated Hospital, Nanjing Medical University, 262 Zhongshan North Rd., Nanjing, 210003, Jiangsu Province, China

    Xiurong Li, Junwei Yang & Li Fang

Authors
  1. Xiurong Li
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  2. Xianlin Xu
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  3. Jinfeng Liu
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  4. Junwei Yang
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  5. Li Fang
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  6. Liying Miao
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  7. Jia Di
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  8. Xiaozhou He
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Correspondence to Xiaozhou He.

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Li, X., Xu, X., Liu, J. et al. HbA1c and survival in maintenance hemodialysis patients with diabetes in Han Chinese population. Int Urol Nephrol 46, 2207–2214 (2014). https://doi.org/10.1007/s11255-014-0764-4

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  • DOI: https://doi.org/10.1007/s11255-014-0764-4

Keywords

  • Hemodialysis
  • Diabetes
  • HbA1c
  • Survival