Association between Markers of Glycemic Control, Cardiovascular Complications and Survival in Type 2 Diabetic Patients with End-Stage Renal Disease

Okada, Tomonari; Nakao, Toshiyuki; Matsumoto, Hiroshi; Shino, Tamami; Nagaoka, Yume; Tomaru, Ryo; Wada, Toshikazu

doi:10.2169/internalmedicine.46.6355

Cited by 73 publications

(50 citation statements)

References 35 publications

(18 reference statements)

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“…Some previous studies have shown the prognostic value of GA levels and the association between GA levels and progression of atherosclerosis in diabetic dialysis patients (20)(21)(22)(23). In the present study, the question of which is a better marker, HbA1c or GA, in diabetic CKD patients was not investigated.…”

Section: Discussionmentioning

confidence: 81%

Influence of Proteinuria on Glycated Albumin Values in Diabetic Patients with Chronic Kidney Disease

et al. 2011

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Background Glycated albumin (GA), which is an alternative glycemic marker, is influenced by factors associated with albumin turnover, and it is not clear whether proteinuria influences GA values in diabetic patients with chronic kidney disease (CKD). Methods We enrolled 94 diabetic patients with CKD stages 3 to 5. GA, glycated hemoglobin, and urinary protein excretion (UP) levels were consecutively obtained in each patient. The correlations between GA and UP and those between changes in GA and UP were examined. Results There was a significant correlation between GA and UP in all cases (r=-0.46, p<0.0001), however no significant correlation was found in cases with UP of 0-3.49 g/day (r=0.01). GA values in cases with UP "3.5 g/day were significantly lower than those in cases with UP <3.5 g/day [UP "3.5 g/day and serum albumin (Alb) !3 g/dL; 12.0 ± 1.3%, UP "3.5 g/day and Alb >3 g/dL; 17.8 ± 4.3%, 0" UP <3.5 g/day; 21.2 ± 4.2%], while no significant difference in HbA1c or glucose levels was found. In cases with a minimum of UP "0.5 g/day, no significant correlation was found between the difference in GA and the difference in UP at the point of maximum UP and minimum UP (r=0.04). Conclusion Nephrotic-range proteinuria decreases GA values independent of the glycemic state, while nonnephrotic range proteinuria has no significant influence on GA values in diabetic CKD patients.

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Section: Discussionmentioning

confidence: 81%

Influence of Proteinuria on Glycated Albumin Values in Diabetic Patients with Chronic Kidney Disease

et al. 2011

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“…In place of HbA1c, glycated albumin (GA) has been shown to be a more accurate marker for glycemic control (6)(7)(8). Several studies have shown the association between mortality, the development of cardiovascular disease, and GA values in these patients (9,10). Other studies have shown the association between arterial stiffness, peripheral vascular calcification, and high GA values in these patients (11,12).…”

Section: Several Studies Have Shown the Association Between Poor Glycmentioning

confidence: 99%

Influence of Age and Nutritional Status on Glycated Albumin Values in Hemodialysis Patients

et al. 2009

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“…An increase in advanced glycation of end products (AGEs) caused by hyperglycemia initiates injury to cells including vascular endothelium, glomeruli, and tubules, which facilitates the appearance of DN eventually. AGEs in the body can be assessed by measuring HbA1c; however, a reduction in levels of both HbA1c and blood glucose does not prevent the kidney from the development of ESRD (Okada et al 2007). Intensive control of blood glucose does not lead to a reduction in mortality of stroke and cardiovascular complications (Mannucci et al 2009), and no difference has been found in mortality between 6.9% of HbA1c in intensive therapy group and 8.4% of HbA1c in the standard therapy group (Duckworth et al 2009).…”

Section: Introductionmentioning

confidence: 99%

Argirein alleviates diabetic nephropathy through attenuating NADPH oxidase, Cx43, and PERK in renal tissue

Xia

Dai

et al. 2011

Naunyn-Schmied Arch Pharmacol

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Diabetic nephropathy (DN) due to microvascular complication is a serious status characterized by continuously progressive until occurrence of the end stage of renal disease. It is attractive to investigate further mechanisms underlying the entity of DN and new drug discovery. We hypothesized that the entity of DN is inflammatory and is characterized by upregulated inflammatory/pro-inflammatory factors such as peroxisome proliferator-activated receptor alpha, NADPH oxidase, endoplasmic reticulum stress (ER stress), and endothelin receptor A (ET(A)) and downregulated connexin 43 (Cx43) in the kidney. Aminoguanidine is a special blocker to advanced glycation end products and argirein, a new compound contains a molecule of rhein linked to L: -arginine by a hydrogen bond. Rhein possesses anti-inflammatory activity and has been chemically modified to produce a new compound diacerein launched in European market for treating osteoarthritis. Argirein with two active molecules rhein and L: -arginine may be effective in suppressing the inflammatory cytokines contributing to the pathogenesis of DN. With a single injection of streptozotocin 65 mg/kg, ip in rats, early diabetic nephropathy was produced and revealed as an increased microalbuminuria, elevated creatinine and urea in serum, associated with upregulation of mRNA and protein of NADPH oxidase p22phox, p47phox, and p67phox and ET(A), upregulated PKR-like eukaryotic initiation factor 2α kinase (PERK), and downregulated Cx43 in the renal tissue. Upregulation of PERK suggested that there is an ER stress involved in the diabetic kidney, along with an increase in inflammatory/pro-inflammatory factors indicating an entity of chronic inflammation. Abnormalities of biomarkers were blunted by either aminoguanidine or argirein significantly. The new compound argirein is potential in alleviating and retarding microvascular complications of diabetes such as DN in clinical settings.

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Association between Markers of Glycemic Control, Cardiovascular Complications and Survival in Type 2 Diabetic Patients with End-Stage Renal Disease

Abstract: Background and Objective The influence of glycemic control on cardiovascular (CV) complications or survival is not clear in diabetic patients with end-stage renal disease (ESRD

Cited by 73 publications

References 35 publications

Influence of Proteinuria on Glycated Albumin Values in Diabetic Patients with Chronic Kidney Disease

Influence of Proteinuria on Glycated Albumin Values in Diabetic Patients with Chronic Kidney Disease

Influence of Age and Nutritional Status on Glycated Albumin Values in Hemodialysis Patients

Argirein alleviates diabetic nephropathy through attenuating NADPH oxidase, Cx43, and PERK in renal tissue

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