The Impact of Carbamylation and Anemia on HbA1c’s Association With Renal Outcomes in Patients With Diabetes and Chronic Kidney Disease
Main finding · HbA1c and CKD progression by C-Alb quartile and anemiaResult — go to the resultAdjusted hazard ratio 1.07 95% CI 1.02–1.13Authors' conclusion
In patients with coexisting diabetes and CKD, the association between HbA1c and CKD progression is modified by carbamylation and anemia.
Study context
- Population
- Patients with diabetes and chronic kidney disease (CKD), Chronic Renal Insufficiency Cohort study; mean eGFR 38.1 mL/min/1.73 m², mean HbA1c 7.5% (58 mmol/mol), median carbamylated albumin (C-Alb) 8.4 mmol/mol
- Participants
- 1,516 patients
- Exposure
- Association of HbA1c with CKD progression, stratified by carbamylated albumin (C-Alb) quartiles and anemia
- Outcome
- CKD progression:
- End-stage kidney disease
- 50% decline in eGFR
- Follow-up
- Median 6.9 years
Methodological detailsChronic Renal Insufficiency Cohort, Cox regression, stratified by C-Alb quartiles and anemia
- Chronic Renal Insufficiency Cohort
- Cox regression
- Stratified by C-Alb quartiles and anemia
Main finding
As reported in the abstract
HbA1c and CKD progression by C-Alb quartile and anemia
Adjusted hazard ratio
1.07
95% CI 1.02–1.13
Higher HbA1c
aHR 1.07 (95% CI 1.02–1.13)
- HbA1c not associated with CKD progression in highest C-Alb quartile; monotonic increase in risk across each lower C-Alb quartile
- P for interaction = 0.022
- Anemia modified the association between HbA1c and CKD progression
- P for interaction = 0.025
- Participants with CKD progression
- 763
Observational data: associations, not effects.
Further findings
- HbA1c was lower in the higher C-Alb quartiles
Original publication
The Impact of Carbamylation and Anemia on HbA1c’s Association With Renal Outcomes in Patients With Diabetes and Chronic Kidney Disease. Diabetes Care. Published 18 November 2022. doi:10.
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