A critical evaluation of glycated protein parameters in advanced nephropathy: A matter of life or death. Time to dispense with the hemoglobin A1C in end-stage kidney disease

摘要

An ideal assay for long-term glycemic control in diabetes would accurately reflect recent serum glucose concentrations and predict hypoglycemia-and hyperglycemia-related complications. Hemoglobin A1C (A1C) remains a widely used and trusted tool for assessing glycemic control in patients who lack advanced nephropathy or anemia. The accuracy and predictive ability of the A1C in those with end-stage kidney disease (ESKD) has recently been called into question. The relationship of A1C to serum glucose concentrations changes markedly in advanced nephropathy, as a lower Al C level is seen for similar glucose levels compared with patients without nephropathy.