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Study shows diabetes tests discrepancies in kidney failure patients
22 Feb 2008
Standard blood glucose tests for diabetics are not an accurate measure of blood sugar levels in patients with kidney failure, research suggests.
According to a study carried out by Wake Forest University Baptist Medical Centre, the standard haemoglobin A1c test (HbA1c) underestimates true blood glucose control in hemodialysis patients.
Published in the journal Kidney International, Researchers focused on 307 patients with diabetes, 258 of these with end-stage kidney disease on haemodialysis and 49 without kidney failure.
The study compared the standard HbA1c test with a newer glycated albumin (GA) test which measures the amount of blood sugar that has reacted with albumin.
Diabetic patients on haemodialysis were found to have higher blood sugars and GA levels despite their lower HbA1c results.
Researchers believe the cause of this discrepancy is that HbA1c depends on red blood cell survival, particularly given that these cells do not live as long in haemodialysis patients.
"Control of blood sugar improves outcomes of diabetic patients, so accurate assessment is critical," said the study's lead author, Barry Freedman.
"This study supports the GA test as a more accurate measure of long-term blood sugar control among diabetic patients who are on haemodialysis."
High levels of blood glucose can present risk factors for developing hardening of the arteries (atherosclerosis) as well as kidney disease, heart attack, stroke, nerve damage and blindness, especially in diabetics undergoing haemodialysis
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