Glycated hemoglobin predicts overall and cardiovascular mortality in non-diabetic hemodialysis patients

WOS: 000348356500003PubMed ID: 25079862Aims: Besides diabetic patients, glycated hemoglobin (HbA(1c)) levels have been reported to predict mortality in non-diabetics patients. However, the importance of HbA(1c) levels in non-diabetic hemodialysis patients still remains unknown. Thus, we aimed to prospectively investigate the impact of HbA(1c) on all-cause and cardiovascular mortality in a large group of prevalent non-diabetic hemodialysis patients. Methods: HbA(1c) was measured quarterly in 489 non-diabetic prevalent hemodialysis patients. Overall and cardiovascular mortality were evaluated over a 3 year follow-up. Results: Mean HbA(1c) level was 4.88 +/- 0.46% (3.5 - 6.9%). During the 28.3 +/- 10.6 months follow-up period, 67 patients (13.7%) died; 31 from cardiovascular causes. In Kaplan-Meier analysis, patients in the lowest ( 5.04%) tertiles had poorer overall survival compared to the middle HbA(1c) tertile (p < 0.001). Adjusted Cox-regression analysis revealed that the highest HbA(1c) tertile was associated with both overall (HR = 3.60, 95% CI 1.57 - 8.27, p = 0.002) and cardiovascular (HR = 6.66, 95% CI 1.51 - 29.4; p = 0.01) mortality. Also, low HbA(1c) levels tended to be associated with overall mortality (HR = 2.26, 95% CI 0.96 - 5.29, p = 0.06). Conclusion: Upper normal HbA(1c) levels are independently associated with cardiovascular and overall mortality in non-diabetic hemodialysis patients, whereas lower HbA(1c) levels are not.Fresenius Medical CareThe present study is related to the Ege University study supported by Fresenius Medical Care, with an unrestricted grant. The sponsor had no role in the study design or conduction, data management or analyses, preparation or submission of the manuscript. E.O. is the chief medical director and M.S.S. is a member of the scientific advisory board of Fresenius Medical Care, Turkey. All other authors declare no conflict of interest