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Submitted: 09 Jul 2018
Accepted: 19 Oct 2018
First published online: 05 Dec 2018
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J Nephropharmacol. 2019;8(1): e5.
doi: 10.15171/npj.2019.05
  Abstract View: 766
  PDF Download: 469

Original

Hemoglobin A1c levels in maintenance hemodialysis patients in India

Madhusudan Vijayan 1,2, Sanjay Moses 1, Sam Nishanth 1, Rajeevalochana Parthasarathy 1, Deepu George 1, Milly Mathew 1, Georgi Abraham 1,2,3 * , Ashok Kumar Das 3, Viswanathan Mohan 4

1 Madras Medical Mission Hospital, Chennai, India
2 Tamilnadu Kidney Research Foundation, Chennai, India
3 Pondicherry Institute of Medical Science, Pondicherry, India
4 Dr. Mohan’s Diabetes Specialities Center, Chennai, India
*Corresponding author: Georgi Abraham, Email: Email: abraham_georgi@yahoo.com

Abstract

Introduction: The optimal hemoglobin A1c (glycated hemoglobin; HbA1c) target in diabetic patients on haemodialysis is not established. Most guidelines suggest a HbA1c target of 7%- 8%%.

Objectives: There is paucity of Indian data on the optimal HbA1c values to be targeted in dialysis patients, and hence this prospective study was undertaken to address this gap.

Patients and Methods: This prospective study was conducted in 61 prevalent maintenance haemodialysis patients with type 2 diabetes mellitus. We looked at the association of HbA1c with 1-year survival and hemoglobin values.

Results: At the end of one year, 38 patients had survived, 10 patients died, 3 patients were transferred to continuous ambulatory peritoneal dialysis, and 10 patients were transferred to other centres. There was a significant relationship between HbA1c levels and blood hemoglobin values (r=0.245, P=0.05). The HbA1c values of non-survived patients (7.350 ± 1.834) were higher than those survived (6.768 ± 1.602), though not statistically significant (P=0.326).

Conclusion: This study shows that in diabetic nephropathy patients, poor glycemic control could be a factor for decreased survival rates on haemodialysis. However, larger prospective studies are required to establish the relationship.

Keywords: Hemoglobin A1c, Dialysis, Diabetic nephropathy, Survival, Glycated hemoglobin, Malnutrition...

Implication for health policy/practice/research/medical education:

We found an association between increased HbA1c and mortality in Indian diabetic patients undergoing hemodialysis, though not statistically significant. Higher HbA1c levels may lead to increased mortality in this population, which needs to be confirmed by larger prospective studies.

Please cite this paper as: Vijayan M, Moses S, Nishanth S, Parthasarathy R, George D, Mathew M, et al. Hemoglobin A1c levels in maintenance hemodialysis patients in India. J Nephropharmacol. 2019;8(1):e05. DOI: 10.15171/npj.2019.05

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