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Glycated hemoglobin predicts overall and cardiovascular mortality in non-diabetic hemodialysis patients

Ebru Sevinc Ok1, Gulay Asci, Huseyin Toz

  • 1Division of Nephrology, Ege University, Izmir, Turkey, Division of Nephrology, University of Heidelberg, Heidelberg, Germany, and Division of Nephrology, Istanbul University, Istanbul, Turkey.

Clinical Nephrology
|August 1, 2014
PubMed

Insights

Higher glycated hemoglobin (HbA1c) levels in non-diabetic hemodialysis patients predict increased mortality. This study found upper normal HbA1c is linked to higher cardiovascular and overall death risk.

Area of Science:

  • Nephrology
  • Endocrinology
  • Clinical Chemistry

Background:

  • Glycated hemoglobin (HbA1c) predicts mortality in diabetic and non-diabetic individuals.
  • The prognostic value of HbA1c in non-diabetic hemodialysis patients remains unclear.

Purpose of the Study:

  • To prospectively investigate the association between HbA1c levels and all-cause and cardiovascular mortality.
  • Focus on a large cohort of prevalent non-diabetic hemodialysis patients.

Main Methods:

  • Quarterly HbA1c measurements in 489 non-diabetic hemodialysis patients.
  • Follow-up for all-cause and cardiovascular mortality over 3 years.

Main Results:

  • Higher HbA1c tertiles (> 5.04%) were significantly associated with increased overall (HR=3.60) and cardiovascular mortality (HR=6.66).
  • Lower HbA1c tertiles (< 4.69%) showed a trend towards higher overall mortality (HR=2.26).
  • Kaplan-Meier analysis indicated poorer survival in the lowest and highest HbA1c groups.

Conclusions:

  • Upper-normal range HbA1c levels are independently linked to higher cardiovascular and overall mortality.
  • Lower HbA1c levels did not show a significant association with mortality in this cohort.
Abstract

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