Comparison of reliability of plasma fructosamine and glycosylated hemoglobin assays for assessing glycemic control in diabetic patients on hemodialysis

Nunoi, Kiyohide; Kodama, Takeko; Sato, Yuho; Iwase, Masanori; Yoshizumi, Hideyuki; Kurimoto, Hiroshi; Nishitani, H; Nakamura, Sukeyuki; Fujishima, Masatoshi

doi:10.1016/0026-0495(91)90077-a

Cited by 15 publications

(11 citation statements)

References 17 publications

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“…HbA1c was found to underestimate glucose measurements in diabetic patients on hemodialysis because of anemia and use of erythropoietin compared with glycated albumin (64–67); there have been recent suggestions to use a correction factor based on the degree of anemia and the erythropoietin dosage (65). Aside from all the above limitations, HbAlc is still considered to be a reasonable index of glycemic control even in patients with ESRD (68–71).…”

Section: Diagnostic Tests Of Glycemic Control In Esrdmentioning

confidence: 99%

“…Thus, fructosamine may be a better choice in situations when HbA1c cannot be reliably measured. As with HbAlc, fructosamine level may be less reliable in renal failure (69,75), and may not be superior to HbA1c in diabetic patients with ESRD (69,71). High urate levels often seen in patients with CKD may interfere with the fructosamine assay and levels may be falsely low with decreased protein levels such as nephrotic syndrome or liver disease, and also affected by increased protein turnover related to dialysis (20).…”

Section: Diagnostic Tests Of Glycemic Control In Esrdmentioning

confidence: 99%

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Glycemic Control and Burnt‐Out Diabetes in ESRD

Kövesdy

Park

Kalantar-Zadeh

2010

Seminars in Dialysis

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Treatment of early diabetes mellitus, the most common cause of chronic kidney disease (CKD), may prevent or slow the progression of diabetic nephropathy and lower mortality and the incidence of cardiovascular disease in the general diabetic population and in patients with early stages of CKD. It is unclear whether glycemic control in patients with advanced CKD, including those with end-stage renal disease (ESRD) who undergo maintenance dialysis treatment is beneficial. Aside from the uncertain benefits of treatment in ESRD, hypoglycemic interventions in this population are also complicated by the complex changes in glucose homeostasis related to decreased kidney function and to dialytic therapies, occasionally leading to spontaneous resolution of hyperglycemia and normalization of hemoglobin A1c levels, a condition which might be termed “burnt-out diabetes”. Further difficulties in ESRD are posed by the complicated pharmacokinetics of antidiabetic medications and the serious flaws in our available diagnostic tools used for monitoring long-term glycemic control. We review the physiology and pathophysiology of glucose homeostasis in advanced CKD and ESRD, the available antidiabetic medications and their specifics related to kidney function, and the diagnostic tools used to monitor the severity of hyperglycemia and the therapeutic effects of available treatments, along with their deficiencies in ESRD. We also review the concept of burnt-out diabetes and summarize the findings of studies that examined outcomes related to glycemic control in diabetic ESRD patients, and emphasize areas in need of further research.

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Section: Diagnostic Tests Of Glycemic Control In Esrdmentioning

confidence: 99%

Section: Diagnostic Tests Of Glycemic Control In Esrdmentioning

confidence: 99%

Glycemic Control and Burnt‐Out Diabetes in ESRD

Kövesdy

Park

Kalantar-Zadeh

2010

Seminars in Dialysis

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“…62 Unlike GA, a large number of clinical trials have reported poor correlations between fructosamine and glycemic control in patients with renal failure. Nunoi et al 63 and Morgan and colleagues 64 demonstrated that fructosamine is not a reliable marker of medium-term integrated blood glucose in diabetic patients with CKD. In a study of 23 diabetic hemodialysis patients, Joy et al 65 showed that fructosamine was not significantly associated with long-term glycemic control in diabetic patients receiving hemodialysis (r = .345, P = .11).…”

Section: -56mentioning

confidence: 99%

Advantages and Pitfalls of Fructosamine and Glycated Albumin in the Diagnosis and Treatment of Diabetes

Danese

Montagnana

Nouvenne

et al. 2015

J Diabetes Sci Technol

162

139

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Diabetes is one of the most severe and frequent human disorders. According to recent statistics, this condition afflicts as many as 382 million persons around the globe, with an estimated prevalence of approximately 8.3% in 2013. At variance with other frequent pathologies such as cardiovascular disease and bacterial infections, the trend toward an increased prevalence is not expected to soon reverse. Worldwide, as many as 592 million individuals may be affected by diabetes in 2035, a remarkable 55% increase in prevalence over the next 2 decades. 1 Due to its high global prevalence and severe, frequently life-threatening complications (eg, retinopathy, nephropathy, neuropathy, cardiovascular disease), diabetes must be regarded as a serious and increasing global health burden. The most recent Standards of Medical Care in Diabetes published by the American Diabetes Association (ADA) emphasize that early diagnosis and monitoring are critical for preventing or delaying the onset of acute complications and lowering the risk of long-term complications of diabetes. 2 The current diagnostic criteria for this condition are based on the presence of (1) glycated hemoglobin (HbA1c) value ≥6.5% (ie, ≥48 mmol/mol), (2) fasting plasma glucose (FPG) ≥126 mg/dL (ie, ≥7.0 mmol/L), (3) 2-hour plasma glucose ≥200 mg/dL (ie, ≥11.1 mmol/L) during an oral glucose tolerance test (OGTT) using a 75 g glucose load, or (4) random plasma glucose ≥200 mg/dL (ie, ≥11.1 mmol/L). An increased risk of diabetes (ie, prediabetes) is defined in the presence of (1) HbA1c value between 5.7-6.4% (ie, 39-46 mmol/mol), (2) FPG between 100-126 mg/dL (ie, 5.6-6.9 mmol/L), (3) 2-hour plasma glucose between 140-199 mg/ dL (ie, 7.8-11.0 mmol/L) during an OGTT. With regard to diabetes monitoring, the glycemic targets for nonpregnant adults with diabetes include HbA1c value <7.0% (ie, <53 mmol/mol), preprandial capillary plasma glucose between 567227D STXXX10.

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“…In addition, these assays are not affected by hemoglobin levels and are minimally affected by shortened red blood cell survival, which are known to influence the levels of HbA1c (22,23). Some data have suggested GA or albumin-corrected fructosamine equal or even superior alternatives to HbA1c in dialysis patients with diabetes (18,19,23,37), but some concluded that HbA1c was the most reliable index and a superior marker of glycemic control (25,38,39). Moreover, the cost of GSP assays was about half that of the A1c test.…”

Section: Discussionmentioning

confidence: 99%