The effect of erythropoietin treatment on glycohemoglobin values in diabetic hemodialysis patients—an examination based on the relationship between glycohemoglobin and glycated albumin—

Abstract

We examined the effect of erythropoietin (EPO) treatment on glycohemoglobin (HbA1c, A1c) values based on the relationship between A1c and glycated albumin (GA) in diabetic hemodialysis (DM-HD) patients. We measured A1c and GA values every two months during 10- to 36-month periods in 24 DM-HD patients and examined the ratio of GA to A1c (GA/A1c) on each occasion. We examined the correlation between GA/A1c values and EPO dose on 170 occasions and tried to estimate A1c and GA values based on the EPO dose. The maximum and minimum GA/A1c values were 4.36±0.66 and 3.44±0.50, respectively in all patients. In 9 patients whose EPO doses remained unchanged for 12 months or longer, these values were 3.91±0.66 and 3.41±0.53, respectively. There was a significant correlation between GA/A1c values and EPO dose (r=0.74, p<0.0001, GA/A1c=3.16+0.008×EPO dose (U/kg/week)). The estimated A1c values corresponding to 20% of the GA values were 6.3, 5.6, 5.1, and 4.6% at EPO doses of 0, 50, 100, and 150 U/kg/week, respectively. The differences between the estimated GA values and measured values were greater than±2% on 40% of all occasions. In conclusion, GA/A1c values tend to be higher and A1c values tend to be lower as EPO doses increase in DM-HD patients. It is possible to estimate A1c and GA values based on the EPO dose, but it is necessary to consider that GA/A1c values often change independently of EPO treatment.