Glycated albumin is a better indicator of the glucose excursion than predialysis glucose and hemoglobin A1c in hemodialysis patients

Background: Glycated albumin (GA) has been reported to be a better indicator of glycemic control than hemoglobin A1c (HbA1c) in diabetic hemodialysis (HD) patients. Methods: We performed a cross-sectional study to evaluate associations between daily glucose profiles based on blood glucose measurements at seven different times a day and their GA, HbA1c, and pre-dialysis glucose levels in 90 HD patients with (n = 46) and without (n = 44) diabetes. Results: The results of a univariate analysis showed that the GA, HbA1c, and pre-dialaysis glucose levels were significantly correlated with the daily glucose profiles. In a multivariate analysis, the GA levels were found to be independently correlated with maximum glucose levels (F = 9.448, P = 0.0028) and mean amplitude of glucose excursion (MAGE, F = 5.169, P = 0.0255), but no significant correlation was found between the HbA1c levels and daily glucose profiles. The pre-dialysis glucose levels were independently correlated with minimum glucose levels (F = 8.336, P = 0.0049). In a stratified analysis, the identical trend was seen in the diabetic HD patients, but an independent correlation was found only between HbA1c values and mean glucose levels in nondiabetic HD patients. Conclusions: GA levels may be a better indicator of glycemic control than HbA1c and pre-dialysis glucose levels, especially as a means of evaluating the glucose excursions in diabetic HD patients. © 2016 The Author(s).