Abstract
[Objective] The status of glycemic control in maintenance hemodialytic patients with diabetes mellitus was assessed by glycated albumin (GA), and the impact on the prognosis was reviewed. [Method] We reviewed eighty-seven patients with diabetes mellitus who received maintenance hemodialysis in Yamanashi-Kosei Hospital from January 1, 2004 to December 31, 2009 (age 65.9±10.9 years old, 60 males and 27 females). GA was measured every month throughout the observation period and the mean value was obtained (mean GA). We examined the influence of mean GA on survival using multivariate Cox proportional-hazard model. The subjects were divided into four groups according to their mean GA, and survival was analyzed by the Kaplan-Meier method. [Result] The observation period was 3.1±2.0 years, and 30 subjects died. The mean GA was 21.9±4.1%. The mean GA and patient age each had a significant impact on death (mean GA : proportional hazard : 1.108 ; 95% confidence interval : 1.013 to 1.213 ; p=0.026, age : proportional hazard : 1.035 ; 95% confidence interval : 1.001 to 1.070 ; p=0.046). The group with a mean GA≥24.23% had significantly poorer survival than the group with a mean GA of 19.05% to 24.02% (p=0.496, log-rank test). [Conclusion] Poor glycemic control in maintenance hemodialytic patients with diabetes mellitus is a risk factor for death. This finding indicates that the careful management of glycemic control in these patients is important.
