Sidar Copur1, Dimitrie Siriopol2, Baris Afsar3, Melis C Comert1, Gizem Uzunkopru1, Alan A Sag4, Alberto Ortiz5, Adrian Covic2, Daniel H van Raalte6, David Z Cherney7,8, Peter Rossing9, Mehmet Kanbay10. 1. Department of Medicine, Koc University School of Medicine, Istanbul, Turkey. 2. Department of Nephrology, Grigore T. Popa' University of Medicine, Iasi, Romania. 3. Department of Medicine, Division of Nephrology, Suleyman Demirel University School of Medicine, Isparta, Turkey. 4. Division of Vascular and Interventional Radiology, Department of Radiology, Duke University Medical Center, Durham, NC, USA. 5. Dialysis Unit, School of Medicine, IIS-Fundacion Jimenez Diaz, Universidad Autónoma de Madrid, Avd. Reyes Católicos 2, 28040, Madrid, Spain. 6. Diabetes Center, Department of Internal Medicine, Amsterdam University Medical Center, Loaction VUMC, Amsterdam, The Netherlands. 7. Toronto General Hospital Research Institute, UHN, Toronto, Canada. 8. Departments of Physiology and Pharmacology and Toxicology, University of Toronto, Toronto, ON, Canada. 9. Steno Diabetes Center Copenhagen, Copenhagen Denmark and University of Copenhagen, Copenhagen, Denmark. 10. Department of Medicine, Division of Nephrology, Koc University School of Medicine, 34010, Istanbul, Turkey. drkanbay@yahoo.com.
Abstract
BACKGROUND AND AIM: HbA1c, the traditional and current gold standard biomarker guiding diabetic management, has been scrutinized for low predictive value for patients with chronic kidney disease due to variables affecting erythrocyte number and turnover. Glycated albumin, the precursor to advanced glycation end products, reflects glycemic status over the preceding 2-3 week period and already outperforms HbA1c for glycemic monitoring. Our aim was to establish whether serum GA can be further used to predict mortality risk in dialysis patients with diabetes mellitus (DM) METHODS: We did systematic review of the literature in PubMed/Medline, Web of Science, Embase (Elsevier) and the Cochrane Central Register of Controlled Trials (Wiley) up to and including February 2020. RESULTS: This meta-analysis included 25,932 dialysis patients across 12 studies with maximum follow-up of 11 years. Higher GA levels were associated with the risk of all-cause mortality in dialysis patients with DM (HR 1.02, 95% CI 1.01 to 1.03, P < 0.001) irrespective of the type of dialysis, whereas higher GA was not associated with cardiovascular mortality (HR 1.03, 95% CI 0.99 to 1.06, P = 0.15) and cardiovascular events (both fatal and non-fatal) (HR 1.03, 95% CI 0.97 to 1.09, P = 0.31) in dialysis patients with DM. CONCLUSION: Serum glycated albumin predicts all-cause mortality risk in dialysis patients with DM. The endpoints of cardiovascular mortality and cardiovascular events trended similarly, but did not reach significance at the current sample size.
BACKGROUND AND AIM: HbA1c, the traditional and current gold standard biomarker guiding diabetic management, has been scrutinized for low predictive value for patients with chronic kidney disease due to variables affecting erythrocyte number and turnover. Glycated albumin, the precursor to advanced glycation end products, reflects glycemic status over the preceding 2-3 week period and already outperforms HbA1c for glycemic monitoring. Our aim was to establish whether serum GA can be further used to predict mortality risk in dialysis patients with diabetes mellitus (DM) METHODS: We did systematic review of the literature in PubMed/Medline, Web of Science, Embase (Elsevier) and the Cochrane Central Register of Controlled Trials (Wiley) up to and including February 2020. RESULTS: This meta-analysis included 25,932 dialysis patients across 12 studies with maximum follow-up of 11 years. Higher GA levels were associated with the risk of all-cause mortality in dialysis patients with DM (HR 1.02, 95% CI 1.01 to 1.03, P < 0.001) irrespective of the type of dialysis, whereas higher GA was not associated with cardiovascular mortality (HR 1.03, 95% CI 0.99 to 1.06, P = 0.15) and cardiovascular events (both fatal and non-fatal) (HR 1.03, 95% CI 0.97 to 1.09, P = 0.31) in dialysis patients with DM. CONCLUSION: Serum glycated albumin predicts all-cause mortality risk in dialysis patients with DM. The endpoints of cardiovascular mortality and cardiovascular events trended similarly, but did not reach significance at the current sample size.
Authors: Raymond Vanholder; Denis Fouque; Griet Glorieux; Gunnar H Heine; Mehmet Kanbay; Francesca Mallamaci; Ziad A Massy; Alberto Ortiz; Patrick Rossignol; Andrzej Wiecek; Carmine Zoccali; Gérard Michel London Journal: Lancet Diabetes Endocrinol Date: 2016-03-03 Impact factor: 32.069
Authors: Daniel Murphy; Charles E McCulloch; Feng Lin; Tanushree Banerjee; Jennifer L Bragg-Gresham; Mark S Eberhardt; Hal Morgenstern; Meda E Pavkov; Rajiv Saran; Neil R Powe; Chi-Yuan Hsu Journal: Ann Intern Med Date: 2016-08-02 Impact factor: 25.391