HDCN Abstract:  ASN Annual Meeting -- San Francisco  

Baveja N, Mittman N, Desiraju B, et al.

Serum Fructosamine (SF) Is an Independent Predictor of Morbidity and Survival in Non-Diabetic (NDM) Hemodialysis (HD) Patients (Pts).

ASN Annual Meeting -- San Francisco
J Am Soc Nephrol (Nov) 18:700A 2007

Elevated levels of SF, an alternative index of glycemic control, have been associated with increased cardiovascular mortality in elderly non-uremic, NDM pts. Insulin resistance is prevalent in CKD pts irrespective of cause, which may explain elevated SF seen in NDM HD pts. We have reported that SF predicts one year outcomes in NDM HD pts.

The objective of this prospective longitidunal study was to further examine the prognostic importance of SF in NDM HD pts. We enrolled 94 NDM HD pts in February 2005 and followed them to May 2007. We recorded demographics, biochemical and clinical data including hospitalizations and episodes of infection. SF level was measured by colorimetry and was corrected for serum albumin. The mean age was 56 years. Fifty-three percent were women and the majority were African-American (81%). Pts who were hospitalized during the study period had higher levels of SF compared to those who were not (769 vs.707, p=0.001). There was no significant difference in HbA1c between pts who were hospitalized or not (p=0.95). SF, but not HbA1C, was directly correlated with the rate of hospitalization (r=0.42, p<0.0001), number of hospital days in all pts(r=0.44, p<0.0001), and number of episodes of infections in pts with AV access(r=0.38, p=0.002). Pts with SF>780 mol/g had poorer survival (Kaplan Meier) compared with pts with SF<718 and 718- 780mol/g (p=0.03).

There was no significant difference in cumulative survival between the pts with HbA1c<5.7% and those with HbA1c5.7%. By multivariate logistic regression analysis, controlling for age, race, gender and months on dialysis at enrollment, SF was significantly associated with mortality (odds ratio, 1.008, p=0.011). In addition, multivariate Coxs regression analysis revealed that SF was a highly significant predictor of mortality (RR=1.011, p<0.0001).

Therefore, for each unit of SF, there was a 1.1% increased mortality risk. In conclusion, SF, but not HbA1C, is associated with morbidity, and independently predicts two year survival of NDM HD pts.

© Copyright 2007-2008, American Society of Nephrology. Reproduced with permission.
Until September of 2008, all ASN abstracts from the 2007 Annual Meeting are available at this link

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