Glycated hemoglobin predicts overall and cardiovascular mortality in non-diabetic hemodialysis patients
Makaleler > Tam Makale · 2014
Yazarlar: Ebru Sevinc OK, Gülay AŞCI, Hüseyin TÖZ, Eberhard RITZ, Fatih KIRCELLI, Mehmet Sukru Sever, Mehmet ÖZKAHYA, Savas SIPAHI, Hamad DHEIR, Devrim BOZKURT, Ziya OMER, Osman Z. SAHIN, Muhittin ERTILAV, Ercan OK
Clinical Nephrology, SCI Expanded İndekslerine Giren Dergi, Uluslararası, Wos, 2014, cilt 82, ss 173-180
DOI: 10.5414/cn108251
Özet
AIMS: Besides diabetic patients, glycated hemoglobin (HbA1c) levels have been reported to predict mortality in non-diabetics patients. However, the importance of HbA1c levels in non-diabetic hemodialysis patients still remains unknown. Thus, we aimed to prospectively investigate the impact of HbA1c on all-cause and cardiovascular mortality in a large group of prevalent non-diabetic hemodialysis patients. METHODS: HbA1c was measured quarterly in 489 non-diabetic prevalent hemodialysis patients. Overall and cardiovascular mortality were evaluated over a 3 year follow-up. RESULTS: Mean HbA1c level was 4.88 ± 0.46% (3.5 - 6.9%). During the 28.3 ± 10.6 months follow-up period, 67 patients (13.7%) died; 31 from cardiovascular causes. In Kaplan-Meier analysis, patients in the lowest (< 4.69%) and highest HbA1c (> 5.04%) tertiles had poorer overall survival compared to the middle HbA1c tertile (p < 0.001). Adjusted Cox-regression analysis revealed that the highest HbA1c tertile was associated with both overall (HR = 3.60, 95% CI 1.57 - 8.27, p = 0.002) and cardiovascular (HR = 6.66, 95% CI 1.51 - 29.4; p = 0.01) mortality. Also, low HbA1c levels tended to be associated with overall mortality (HR = 2.26, 95% CI 0.96 - 5.29, p = 0.06). CONCLUSION: Upper normal HbA1c levels are independently associated with cardiovascular and overall mortality in non-diabetic hemodialysis patients, whereas lower HbA1c levels are not.