Renal Replacement Therapy (Apr 2020)
Usefulness of glycated albumin as a predictor of mortality in chronic hemodialysis patients with diabetes: a multi-center, prospective cohort study
- Ko Hanai,
- Makoto Akamatsu,
- Aki Fujimori,
- Harumichi Higashi,
- Yumiko Horie,
- Yoshiaki Itaya,
- Minoru Ito,
- Tomoko Kanamaru,
- Hiroshi Kawaguchi,
- Kan Kikuchi,
- Hideo Kobayashi,
- Machiko Komatsu,
- Takao Kubota,
- Kenichi Kudo,
- Satoshi Kurihara,
- Ikuto Masakane,
- Junichiro Mera,
- Sonoo Mizuiri,
- Kimiko Moriyama,
- Junichiro Nagasawa,
- Sumiyo Nagata,
- Yoshihiko Nakagawa,
- Satoshi Nakazato,
- Takahiro Nishi,
- Yoshihiko Noma,
- Naoyuki Odaguchi,
- Senji Okuno,
- Shiwori Osada,
- Hisashi Ozasa,
- Sumihiko Sato,
- Tokihiko Sawada,
- Tsuyako Shimajiri,
- Yukiko Shimamoto,
- Masakazu Suda,
- Toshihide Suzuki,
- Hiromichi Suzuki,
- Maki Takahashi,
- Hajime Takahashi,
- Toshimasa Takahashi,
- Yoshihiro Takebayashi,
- Masanobu Takeda,
- Hiroyuki Tamura,
- Yoshiko Tanaka,
- Sohei Tokunaka,
- Shinji Tsuda,
- Mio Ueda,
- Ichiro Yamaguchi,
- Hirohisa Yamamoto,
- Yasuko Uchigata,
- Tetsuya Babazono
Affiliations
- Ko Hanai
- Diabetes Center, Tokyo Women’s Medical University School of Medicine
- Makoto Akamatsu
- Akamatsu Touseki Clinic
- Aki Fujimori
- Shinbashi Naika Clinic
- Harumichi Higashi
- Our Lady of the Snow Social Medical Corporation St. Mary’s Hospital
- Yumiko Horie
- Yamanouchi Hospital
- Yoshiaki Itaya
- Kameido Nephrology Clinic
- Minoru Ito
- Yabuki Hospital
- Tomoko Kanamaru
- Tokorozawa Ishikawa Clinic
- Hiroshi Kawaguchi
- Jyoban Hospital
- Kan Kikuchi
- Shimoochiai Clinic
- Hideo Kobayashi
- Suda Clinic
- Machiko Komatsu
- Kawashima Hospital, Social Medical Corporation Kawashima Hospital Group
- Takao Kubota
- Yagi Naika Clinic
- Kenichi Kudo
- Honcho Yabuki Clinic
- Satoshi Kurihara
- Saitama-Tsukinomori Clinic
- Ikuto Masakane
- Yabuki Hospital
- Junichiro Mera
- Shinsen-Ikebukuro Clinic
- Sonoo Mizuiri
- Ichiyokai Harada Hospital
- Kimiko Moriyama
- Nisshin Ekimae Clinic
- Junichiro Nagasawa
- Tendouonsen Yabuki Clinic
- Sumiyo Nagata
- Yokohama Chuo Clinic
- Yoshihiko Nakagawa
- Minami-cho Clinic
- Satoshi Nakazato
- Chibana Clinic
- Takahiro Nishi
- Nishi Clinic
- Yoshihiko Noma
- Kawashima Hospital, Social Medical Corporation Kawashima Hospital Group
- Naoyuki Odaguchi
- Chibana Clinic
- Senji Okuno
- Shirasagi Hospital
- Shiwori Osada
- Tokyo Ayase Kidney Clinic
- Hisashi Ozasa
- Minami Ikebukuro Clinic
- Sumihiko Sato
- Credo Sato Clinic
- Tokihiko Sawada
- Toshima Chuo Hospital
- Tsuyako Shimajiri
- Chibana Clinic
- Yukiko Shimamoto
- Ohmiya Nishiguchi Clinic
- Masakazu Suda
- Suda Medical Clinic
- Toshihide Suzuki
- Iidabashi Suzuki Internal Medicine
- Hiromichi Suzuki
- Department of Nephrology Saitama Medical University
- Maki Takahashi
- Suda Naika Clinic
- Hajime Takahashi
- Hibiya Ishikawa Clinic
- Toshimasa Takahashi
- Bosei Shinjuku Minamiguchi Clinic
- Yoshihiro Takebayashi
- Hibiya Ishikawa Clinic
- Masanobu Takeda
- Yamanouchi Hospital
- Hiroyuki Tamura
- Toshima Chuo Hospital
- Yoshiko Tanaka
- Shinjuku Ishikawa Clinic
- Sohei Tokunaka
- Kokuryo Ishikawa Clinic
- Shinji Tsuda
- Shin-Nakano Dialysis Clinic
- Mio Ueda
- Kokuryo Ishikawa Clinic
- Ichiro Yamaguchi
- Tendouonsen Yabuki Clinic
- Hirohisa Yamamoto
- Kawagoe Ekimae Clinic
- Yasuko Uchigata
- Diabetes Center, Tokyo Women’s Medical University School of Medicine
- Tetsuya Babazono
- Diabetes Center, Tokyo Women’s Medical University School of Medicine
- DOI
- https://doi.org/10.1186/s41100-020-00264-1
- Journal volume & issue
-
Vol. 6,
no. 1
pp. 1 – 8
Abstract
Abstract Background The association of glycated albumin (GA) with mortality is unclear in chronic hemodialysis patients with diabetes. We investigated the usefulness of GA by comparing it with hemoglobin A1c (HbA1c) in this patient population. Research design and methods This was a multi-center, prospective cohort study of 841 Japanese chronic hemodialysis patients with diabetes. There were 235 women and 606 men included, with a mean age of 64 years. The primary and secondary endpoints were the incidence of all-cause and cause-specific mortality, respectively. The hazard ratios of GA and HbA1c for the endpoints were estimated using the values at baseline and during the study period. Results During the mean follow-up period of 3.1 years, there were 184 deceased cases, in which 30 and 154 resulted from atherosclerotic cardiovascular disease (ASCVD) and non-ASCVD, respectively. The hazard ratio for a 1% increase in GA was 1.033 (95% confidence interval 1.006–1.060, p = 0.017) for all-cause mortality with a statistical significance when GA was treated as a time dependent variable, but not when the baseline levels or the mean levels during the follow-up period were used in the analysis (p = 0.815 and 0.517, respectively). GA was a significant predictor for ASCVD-related mortality in the above 3 models, but was not for non-ASCVD mortality. Higher levels of HbA1c were only associated with ASCVD-related mortality when HbA1c was treated as a time-dependent variable. Conclusions GA may be useful compared to HbA1c for predicting all-cause and ASCVD-related mortality in Japanese patients with diabetes undergoing chronic hemodialysis.