Poor Glycemic Control is a Significant Predictor of Cardiovascular Events in Chronic Hemodialysis Patients With Diabetes

2009 ◽  
Vol 13 (4) ◽  
pp. 358-365 ◽  
Author(s):  
Yoshihiro Tsujimoto ◽  
Eiji Ishimura ◽  
Hideki Tahara ◽  
Ryuusuke Kakiya ◽  
Hidenori Koyama ◽  
...  
Keyword(s):  
Glycemic Control ◽  
Cardiovascular Events ◽  
Hemodialysis Patients ◽  
Chronic Hemodialysis ◽  
Poor Glycemic Control ◽  
Patients With Diabetes

Comparison of Glycemic Markers in Chronic Hemodialysis Using Continuous Glucose Monitoring

2017 ◽  
Vol 47 (1) ◽  
pp. 21-29 ◽  
Author(s):  
Maria Divani ◽  
Panagiotis I. Georgianos ◽  
Triantafyllos Didangelos ◽  
Fotios Iliadis ◽  
Areti Makedou ◽  
...  
Keyword(s):  
Glycemic Control ◽  
Continuous Glucose Monitoring ◽  
Glycated Albumin ◽  
Glucose Monitoring ◽  
Standard Of Care ◽  
Hemodialysis Patients ◽  
Chronic Hemodialysis ◽  
Poor Glycemic Control ◽  
Area Under Roc Curve ◽  
Average Glucose

Background: Glycated hemoglobin A1c (HbA1c) among diabetic hemodialysis patients continues to be the standard of care, although its limitations are well recognized. This study evaluated glycated albumin (GA) and glycated serum protein (GSP) as alternatives to HbA1c in detecting glycemic control among diabetic hemodialysis patients using continuous-glucose-monitoring (CGM)-derived glucose as reference standard. Methods: A CGM system (iPRO) was applied for 7 days in 37 diabetic hemodialysis patients to determine glycemic control. The accuracy of GA and GSP versus HbA1c in detecting a 7-day average glucose ≥184 mg/dL was evaluated via receiver-operating-characteristic (ROC) analysis. Results: CGM-derived glucose exhibited strong correlation (r = 0.970, p < 0.001) and acceptable agreement with corresponding capillary glucose measurements obtained by the patients themselves in 1,169 time-points over the 7-day-long CGM. The area under ROC curve (AUC) for GA, GSP, and HbA1c to detect poor glycemic control was 0.976 (0.862–1.000), 0.682 (0.502–0.862), and 0.776 (0.629–0.923) respectively. GA levels >20.3% had 90.9% sensitivity and 96.1% specificity in detecting a 7-day average glucose ≥184 mg/dL. The AUC for GA was significantly higher than the AUC for GSP (difference between areas: 0.294, p < 0.001) and the AUC for HbA1c (difference between areas: 0.199, p < 0.01). Conclusion: Among diabetic hemodialysis patients, GA is a stronger indicator of poor glycemic control assessed with 7-day-long CGM when compared to GSP and HbA1c.

Glycemic Control and Infections among U.S. Hemodialysis Patients with Diabetes Mellitus

Diabetes ◽  
2018 ◽  
Vol 67 (Supplement 1) ◽  
pp. 1588-P
Author(s):  
JINNIE J. RHEE ◽  
YUANCHAO ZHENG ◽  
MARIA MONTEZ-RATH ◽  
WOLFGANG WINKELMAYER
Keyword(s):  
Diabetes Mellitus ◽  
Glycemic Control ◽  
Hemodialysis Patients ◽  
Patients With Diabetes

Higher Serum Bisphenol A Levels in Diabetic Hemodialysis Patients

2016 ◽  
Vol 42 (1) ◽  
pp. 77-82 ◽  
Author(s):  
Faruk Turgut ◽  
Sana Sungur ◽  
Ramazan Okur ◽  
Mustafa Yaprak ◽  
Muge Ozsan ◽  
...  
Keyword(s):  
Bisphenol A ◽  
High Performance ◽  
Patient Characteristics ◽  
Hemodialysis Patients ◽  
Chronic Hemodialysis ◽  
Dialysis Session ◽  
Laboratory Parameters ◽  
Hemodialysis Session ◽  
Before And After ◽  
Patients With Diabetes

Background: Bisphenol A (BPA) has been implicated as an ‘endocrine disruptor'. We aimed at exploring the association between serum BPA levels and patient characteristics, particularly the presence of diabetes mellitus, and laboratory parameters in hemodialysis patients. Methods: This study included 47 chronic hemodialysis patients. Patient characteristics were recorded. Blood was drawn before and after hemodialysis session. Serum BPA levels were measured by the high-performance-liquid-chromatography and laboratory parameters were measured by using standard methods. Results: In hemodialysis patients, postdialysis serum BPA levels were significantly higher than predialysis after a single hemodialysis session (5.57 ± 1.2 vs. 4.06 ± 0.73, p < 0.0001). Predialysis serum BPA levels were significantly higher in patients with diabetes than non-diabetics (4.4 ± 0.6 vs. 3.9 ± 0.7, p = 0.025). No association was found between serum BPA levels and patient characteristics, and particularly laboratory parameters. Conclusion: Serum BPA levels were rising significantly after a single dialysis session. Diabetic hemodialysis patients had higher predialysis serum BPA levels.

scholarly journals Glycemic Control and Infections Among US Hemodialysis Patients With Diabetes Mellitus

2020 ◽  
Vol 5 (7) ◽  
pp. 1014-1025 ◽  
Author(s):  
Jinnie J. Rhee ◽  
Yuanchao Zheng ◽  
Sai Liu ◽  
Maria E. Montez-Rath ◽  
Richard J. Hamill ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Glycemic Control ◽  
Hemodialysis Patients ◽  
Patients With Diabetes

scholarly journals Glycemic Control and Cardiovascular Mortality in Hemodialysis Patients With Diabetes: A 6-Year Cohort Study

Diabetes ◽  
2012 ◽  
Vol 61 (3) ◽  
pp. 708-715 ◽  
Author(s):  
J. Ricks ◽  
M. Z. Molnar ◽  
C. P. Kovesdy ◽  
A. Shah ◽  
A. R. Nissenson ◽  
...  
Keyword(s):  
Cohort Study ◽  
Glycemic Control ◽  
Cardiovascular Mortality ◽  
Hemodialysis Patients ◽  
Patients With Diabetes

scholarly journals Glycemic Control and Cardiovascular Events in Diabetic Hemodialysis Patients

Circulation ◽  
2009 ◽  
Vol 120 (24) ◽  
pp. 2421-2428 ◽  
Author(s):  
Christiane Drechsler ◽  
Vera Krane ◽  
Eberhard Ritz ◽  
Winfried März ◽  
Christoph Wanner
Keyword(s):  
Glycemic Control ◽  
Cardiovascular Events ◽  
Hemodialysis Patients

scholarly journals Barriers to care in patients with diabetes and poor glycemic control—A cross-sectional survey

PLoS ONE ◽  
2017 ◽  
Vol 12 (5) ◽  
pp. e0176135 ◽  
Author(s):  
Kerry A. McBrien ◽  
Christopher Naugler ◽  
Noah Ivers ◽  
Robert G. Weaver ◽  
David Campbell ◽  
...  
Keyword(s):  
Glycemic Control ◽  
Barriers To Care ◽  
Poor Glycemic Control ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Patients With Diabetes

Antibodies to the Platelet Factor 4-Heparin Complex and Mortality in Chronic Hemodialysis Patients.

Blood ◽  
2006 ◽  
Vol 108 (11) ◽  
pp. 274-274
Author(s):  
Marc Carrier ◽  
Greg A. Knoll ◽  
Dean Fergusson ◽  
Steven Doucette ◽  
Michael J. Kovacs ◽  
...  
Keyword(s):  
Cardiovascular Events ◽  
Hemodialysis Patients ◽  
Serotonin Release ◽  
Chronic Hemodialysis ◽  
Platelet Factor 4 ◽  
Elisa Assay ◽  
Platelet Factor ◽  
Risk Of Death ◽  
Asymptomatic Patients ◽  
Release Assay

Abstract Background: Heparin-induced thrombocytopenia is a serious complication of heparin therapy that can lead to thromboembolism, cardiovascular events or death. Patients with this disorder develop antibodies to the platelet factor 4-heparin (PF4-H) complex. Hemodialysis patients are repeatedly exposed to heparin and are at risk for developing PF4-H antibodies. The clinical impact of asymptomatic PF4-H antibodies in patients on chronic hemodialysis is not known. Objective: To determine the association between asymptomatic PF4-H antibodies and mortality in a cohort of chronic hemodialysis patients repeatedly exposed to heparin. Methods: Pre-dialysis blood samples were drawn from 419 asymptomatic patients. All patients received unfractionated heparin (Baxter) while on dialysis. All samples were screened for PF4-H antibodies using an ELISA assay (GTI PF4 Enhanced, GTI Diagnostics). All positive and indeterminate samples were then tested using an IgG-specific PF4-H ELISA assay and a platelet serotonin-release assay. Participants were then followed up prospectively for thromboembolic events, cardiovascular events, or death. Results: During a median follow-up of 2.5 years there were 129 deaths. After controlling for important potential confounding variables, the relative risk of death was 2.92 (95% CI: 1.18-7.25; P= 0.02) in patients with IgG-specific PF4-H antibodies and 4.08 (95% CI: 1.26–13.2; P= 0.02) in patients with IgG-specific antibodies and an indeterminate serotonin-release assay. Conclusions: PF4-H antibody formation is associated with increased all-cause mortality in patients on chronic hemodialysis. Further investigation is needed to determine if anticoagulation with alternative agents would improve survival in this population.

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