Key result
Baseline HbA1c >9% in diabetic patients with stage 3-4 chronic kidney disease was associated with a higher risk of end-stage renal disease (HR 1.6; 95% CI 1.07-2.38), but not in stage 5 CKD.
Cohort (n=2,401)
Hazard Ratio: 1.6 (95% CI 1.07–2.38)
Diabetes is the major risk factor for end-stage renal disease (ESRD) worldwide. In advanced chronic kidney disease (CKD), less is known about the predictive value of HbA1c. We enrolled 2401 diabetic patients with stage 3-4 and stage 5 CKD, who were classified into 4 groups according to their baseline HbA1c values (<6%, 6%-7%, 7%-9%, and >9%). During the median follow-up of 3 years, 895 patients developed ESRD, and 530 died. In linear regression analysis, higher HbA1c correlated with higher eGFR in patients with stage 5 CKD but not in stage 3-4 CKD. In Cox regression analysis, a trend toward worse clinical outcomes existed when the HbA1c level exceeded 6% in stage 3-4 CKD, but the significance was only observed for >9%. The hazard ratios (HRs) for ESRD, all-cause mortality and combined CV events with mortality in the group of HbA1c >9% were 1.6 (95% CI, 1.07 to 2.38), 1.52 (95% CI, 0.97 to 2.38) and 1.46 (95% CI, 1.02 to 2.09), respectively. This study demonstrates that the higher HbA1c level is associated higher risks for clinical outcomes in diabetic patients with stage 3-4 CKD but not in stage 5 CKD.
No takes yet. Share an insight, caveat, or question.
Kuo et al. (2016) conducted a cohort in Diabetic chronic kidney disease (stage 3-4 and stage 5) (n=2,401). HbA1c >9% vs. Lower HbA1c values was evaluated on End-stage renal disease (ESRD) (HR 1.6, 95% CI 1.07 to 2.38). Baseline HbA1c >9% in diabetic patients with stage 3-4 chronic kidney disease was associated with a higher risk of end-stage renal disease (HR 1.6; 95% CI 1.07-2.38), but not in stage 5 CKD.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: