| Theme | Dialysis in Diabetic Patients | |
|---|---|---|
| Title | Determining proper target levels of HbA1C or glycoalbumin for good prognoses for diabetic hemodialysis patients | |
| Publish Date | 2005/01 | |
| Author | Yoshiko Tanaka | Department of Dialysis, Koshin Clinic |
| Author | Madoka Saito | Department of Dialysis, Koshin Clinic |
| Author | Masako Yasuda | Department of Dialysis, Koshin Clinic |
| Author | Osamu Tomonaga | Department of Dialysis, Koshin Clinic |
| Author | Naoki Kimata | Department of Blood Purification, Tokyo Women's Medical University |
| Author | Takashi Akiba | Department of Blood Purification, Tokyo Women's Medical University |
| [ Summary ] | To prevent the progression of diabetic microangiopathy to the HbA1C level (<6.5 %) it is proposed that patients not receive nephropathy. But there is no clear consensus concerning target levels for HbA1C or glycoalbumin (GA) to produce good prognoses for diabetic dialysis (DM-HD) patients. It has been proposed that in DM-HD patients, HbA1C tends to be measured at lower values than in the actual glycemic control states because of a high turnover of hemoglobin from the administration of erythropoietin (rHuEPO) to improve renal anemia. Our recent study confirmed that higher rHuEPO dosages are associated with lower HbA1C values measured in hemodialysis patients. We suggest that the target for HbA1C should be 5.9 % (rHuEPO dose 0 / week), 5.5 % (to 3,000 lU / week), 5.1 % (to 6,000 lU / week), 4.9 % (to 9,000 lU / week) in DM-HD patients for the prevention of complications. These levels are compatible with the guidelines data on HbA1C 6.5 % for non-uremic patients. GA, not affected by rHuEPO, may be a good index for DM-HD patients, whose rHuEPO doses are frequently changed. | |