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Abstract: ASN Annual Meeting -- San Francisco |
Duong U, Mehrotra R, Kovesdy CP, et al.
Examining the Mortality-Predictability of Hemoglobin A1c in Chronic Peritoneal Dialysis Patients in the USA.
ASN Annual Meeting -- San Francisco
J Am Soc Nephrol (Nov) 18:697A 2007
Background: A recent study showed that in diabetic hemodialysis patients (pts), higher A1c is associated with death risk (Kalantar-Zadeh et al, Diabetes Care 2007). The association between A1c and survival in chronic peritoneal dialysis (CPD) pts may be confounded by glucose loading in PD fluid, leading to worsened metabolic control in CPD.
Methods: We examined a large contemporary cohort of all CPD pts who underwent dialysis treatment for at least 3 months in any DaVita dialysis clinic during 7/2001- 6/2004. In 2,878 CPD pts including 2,452 diabetics at least one A1c measure was available. Pts were 46.59.5 yrs old and included 45% women, 20% Blacks and 18% Hispanics.
Results: Using continuous A1c in survival models, there was no association between A1c and survival. A1c was then categorized into 6 groups of <5%, >9% and 1% increments inbetween, but no association was noted:
A1c was then examined exclusively in diabetic CPD pts by categorizing A1c to <6%, 6-7.9%, 8-9.9% and10%. A U-shaped trend with non-significant death hazard ratios (HR) was noted. When the A1c of 8-9.9% was used as the reference for its lowest death HR, the A1c
Conclusions: In this national cohort of diabetic CPD patients A1c does not appear associated with survival.
© Copyright 2007-2008, American Society of Nephrology. Reproduced with permission.
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