末期腎不全糖尿病患者における血糖管理指標 : HbA1c の問題点

We have investigated the validity of HbA1c values measured as the index of glycemic controls in diabetics with end-stage renal disease（ESRD）. HbA1c levels for diabetics with ESRD undergoing haemodialysis were lower than indicated by their blood glucose control. However, the changes in glycated albumin in relation to the blood glucose control in the dialysis patients matched those in diabetics without renal dysfunction. Diabetics with stage４or５chronic kidney disease（CKD）not on haemodialysis had significantly lower values of HbA1c and shorter RBC lifespan compared with patients without renal dysfunction. When assessing blood glucose control based solely on HbA1c, erroneous result may be obtained in diabetics with ESRD.