並列タイトル等2型糖尿病血液透析患者のグリコアルブミンに対するアルブミン漏出の影響
Albumin leakage and glycoalbumin in patients with diabetes undergoing hemodialysis
タイトル（掲載誌）Journal of Artificial Organs
一般注記Glycated albumin (GA) is recommended as a better glycemic indicator than HbA1c in patients undergoing hemodialysis, because red blood cell lifespan is generally faster than that in normal subjects and easily altered by blood loss and erythropoiesis-stimulating agent administration. However, GA can be also affected by protein loss in urine and hemodialysis fluid. Therefore, in this study, we investigated the effect of albumin leakage induced by hemodialysis on GA in a crossover manner. Nine patients undergoing hemodialysis with large or small amounts of albumin leakage were observed for nine months. Valuables indicating glycemic control, albumin and hemoglobin metabolism and nutritional status were evaluated. As a result, it was shown that albumin leakage could affect GA, but the effect was practically small considering the prescription of diabetic drugs. The correlation between HbA1c and blood glucose levels was similar with that between GA and blood glucose levels in our study. In conclusion, GA was a reliable indicator, even with the change of hemodialysis modality. The influence of clinically acceptable albumin leakage induced by hemodialysis on GA was negligible practically. We should recognize that the preferable glycemic indicator in patients undergoing hemodialysis depends on the hemoglobin and albumin metabolism of each patient.
DOIinfo:doi/10.1007/s10047-019-01097-4
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