The usefulness of glycated albumin in patients with diabetes and renal disease: a scoping review

Background: Diabetes kidney disease (DKD) is one of the main complications in patients with diabetes and good control of glycaemia is very important since earlier stages of chronic kidney disease (CKD). Glycated haemoglobin (HbA1c) is the traditional test for glycaemic monitoring nevertheless may be influenced by several pathophysiological conditions that limited its use in patients with CKD. Glycated albumin (GA) is a promising test as a potential marker of glycaemic control. This scoping review aimed to summarizes the evidences in the literature about the usefulness and limitations of GA as a glycaemic marker in diabetic patients with DKD. Methods: This is a review with a systematic search of literature. We searched PubMed (MEDLINE) for reports published up to May 2021 using the search terms related to diabetes, GA and renal disease combined. Results: Sixty-one studies met our inclusion criteria and were included in the qualitative synthesis of this review. These studies were related to glycaemic control (n=27), outcomes (n=30), technical aspects of GA measurement (n=1), diabetes mellitus post -transplant (DMPT; n=1), and interfering factors in GA analysis (n=4). GA and HbA1c are similarly associated with glycaemia and may be used as indicators of glycaemic control. Furthermore, GA is associated with the risk of mortality in patients with diabetes undergoing dialysis and showed positive association with microvascular complications in patients with diabetes with early DKD. Conclusions: In conclusion, GA may be an alternative marker of glycaemic control when conditions that affect HbA1c are present and may be a promisor biomarker for the management of diabetes mellitus (DM) patients with and without CKD.