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García-Maset R, Bover J, Segura de la Morena J, Goicoechea Diezhandino M, Cebollada Del Hoyo J, Escalada San Martin J, Fácila Rubio L, Gamarra Ortiz J, García-Donaire JA, García-Matarín L, Gràcia Garcia S, Isabel Gutiérrez Pérez M, Hernández Moreno J, Mazón Ramos P, Montañés Bermudez R, Muñoz Torres M, de Pablos-Velasco P, Pérez-Maraver M, Suárez Fernández C, Tranche Iparraguirre S, Luis Górriz J. Information and consensus document for the detection and management of chronic kidney disease. Nefrologia 2022; 42:233-264. [PMID: 36210616 DOI: 10.1016/j.nefroe.2022.07.003] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2021] [Accepted: 07/20/2021] [Indexed: 06/16/2023] Open
Abstract
Chronic kidney disease (CKD) is a major public health problem worldwide that affects more than 10% of the Spanish population. CKD is associated with high comorbidity rates, poor prognosis and major consumption of health system resources. Since the publication of the last consensus document on CKD seven years ago, little evidence has emerged and few clinical trials on new diagnostic and treatment strategies in CKD have been conducted, apart from new trials in diabetic kidney disease. Therefore, CKD international guidelines have not been recently updated. The rigidity and conservative attitude of the guidelines should not prevent the publication of updates in knowledge about certain matters that may be key in detecting CKD and managing patients with this disease. This document, also prepared by 10 scientific associations, provides an update on concepts, clarifications, diagnostic criteria, remission strategies and new treatment options. The evidence and the main studies published on these aspects of CKD have been reviewed. This should be considered more as an information document on CKD. It includes an update on CKD detection, risk factors and screening; a definition of renal progression; an update of remission criteria with new suggestions in the older population; CKD monitoring and prevention strategies; management of associated comorbidities, particularly in diabetes mellitus; roles of the Primary Care physician in CKD management; and what not to do in Nephrology. The aim of the document is to serve as an aid in the multidisciplinary management of the patient with CKD based on current recommendations and knowledge.
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Affiliation(s)
| | | | - Julián Segura de la Morena
- Sociedad Española de Hipertensión-Liga Española para la Lucha contra la Hipertensión Arterial (SEH-LELHA)
| | | | | | | | | | | | - Jose A García-Donaire
- Sociedad Española de Hipertensión-Liga Española para la Lucha contra la Hipertensión Arterial (SEH-LELHA)
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2
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Documento de información y consenso para la detección y manejo de la enfermedad renal crónica. Nefrologia 2022. [DOI: 10.1016/j.nefro.2021.07.010] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
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Ben-David E, Hull R, Banerjee D. Diabetes mellitus in dialysis and renal transplantation. Ther Adv Endocrinol Metab 2021; 12:20420188211048663. [PMID: 34631007 PMCID: PMC8495524 DOI: 10.1177/20420188211048663] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/14/2021] [Accepted: 08/29/2021] [Indexed: 12/31/2022] Open
Abstract
Diabetes mellitus is the commonest cause of end-stage kidney failure worldwide and is a proven and significant risk factor for the development of cardiovascular disease. Renal impairment has a significant impact on the physiology of glucose homeostasis as it reduces tissue sensitivity to insulin and reduces insulin clearance. Renal replacement therapy itself affects glucose control: peritoneal dialysis may induce hyperglycaemia due to glucose-rich dialysate and haemodialysis often causes hypoglycaemia due to the relatively low concentration of glucose in the dialysate. Autonomic neuropathy which is common in chronic kidney disease (CKD) and diabetes increases the risk for asymptomatic hypoglycaemia. Pharmacological options for improving glycaemic control are limited due to alterations to drug metabolism. Impaired glucose tolerance and diabetes are also common in the post-kidney-transplant setting and increase the risk of graft failure and mortality. This review seeks to summarise the literature and tackle the intricacies of glycaemic management in patients with CKD who are either on maintenance haemodialysis or have received a kidney transplant. It outlines changes to glycaemic targets, monitoring of glycaemic control, the use of oral hypoglycaemic agents, the management of severe hyperglycaemia in dialysis and kidney transplantation patients.
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Affiliation(s)
- Eyal Ben-David
- Renal and Transplantation Unit, St George's University Hospitals NHS Foundation Trust, London, UK
| | - Richard Hull
- Renal and Transplantation Unit, St George's University Hospitals NHS Foundation Trust, London, UK
| | - Debasish Banerjee
- Renal and Transplantation Unit, St George's University Hospitals NHS Foundation Trust, Room G2.113, Second Floor, Grosvenor Wing, Blackshaw Road, Tooting, London SW17 0QT, UK
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Passadakis P, Thodis E, Vargemezis V, Oreopoulos G. Recommendations for glucose control in diabetics on CAPD. Int J Artif Organs 2018. [DOI: 10.1177/039139889902201001] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
- P. Passadakis
- General Hospital of Alexandroupolis, Democritus of Thrace University
| | - E. Thodis
- General Hospital of Alexandroupolis, Democritus of Thrace University
| | - V. Vargemezis
- General Hospital of Alexandroupolis, Democritus of Thrace University
| | - G. Oreopoulos
- General Hospital of Alexandroupolis, Democritus of Thrace University
- The Toronto Hospital (Western Division) and University of Toronto, Toronto, Ontario - Canada
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Martínez-Castelao A, Górriz JL, Bover J, Segura-de la Morena J, Cebollada J, Escalada J, Esmatjes E, Fácila L, Gamarra J, Gràcia S, Hernández-Moreno J, Llisterri-Caro JL, Mazón P, Montañés R, Morales-Olivas F, Muñoz-Torres M, de Pablos-Velasco P, de Santiago A, Sánchez-Celaya M, Suárez C, Tranche S. Documento de consenso para la detección y manejo de la enfermedad renal crónica. ACTA ACUST UNITED AC 2014; 61:e25-43. [DOI: 10.1016/j.endonu.2014.06.003] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2014] [Accepted: 06/20/2014] [Indexed: 02/07/2023]
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Martínez-Castelao A, Górriz JL, Bover J, Segura-de la Morena J, Cebollada J, Escalada J, Esmatjes E, Fácila L, Gamarra J, Gràcia S, Hernández-Moreno J, Llisterri-Caro JL, Mazón P, Montañés R, Morales-Olivas F, Muñoz-Torres M, de Pablos-Velasco P, de Santiago A, Sánchez-Celaya M, Suárez C, Tranche S. [Consensus document for the detection and management of chronic kidney disease]. Aten Primaria 2014; 46:501-19. [PMID: 25288498 PMCID: PMC6983829 DOI: 10.1016/j.aprim.2014.09.002] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2014] [Accepted: 09/08/2014] [Indexed: 02/07/2023] Open
Abstract
La enfermedad renal crónica (ERC) es un importante problema de salud pública que puede afectar en sus diferentes estadios a cerca del 10% de la población española y que supone una elevada morbimortalidad, así como un importante consumo de recursos al Sistema Nacional de Salud. Diez sociedades científicas involucradas en el manejo del paciente renal nos hemos puesto de acuerdo para hacer una puesta al día del anterior documento de consenso sobre ERC de 2007. El presente es la edición abreviada del documento general extenso, que puede ser consultado en las páginas Web de cada una de las sociedades firmantes. Contiene los siguientes aspectos: definición, epidemiología y factores de riesgo de la ERC; criterios de diagnóstico, evaluación y estadificación de la ERC, albuminuria y estimación del filtrado glomerular; concepto y factores de progresión; criterios de derivación a nefrología; seguimiento del paciente, actitudes y objetivos por especialidad; prevención de la nefrotoxicidad; detección del daño cardiovascular; actitudes, estilo de vida y tratamiento: manejo de la hipertensión arterial, dislipidemia, hiperglucemia, tabaquismo, obesidad, hiperuricemia, anemia, alteraciones del metabolismo mineral y óseo; seguimiento coordinado por atención primaria-otras especialidades-nefrología; manejo del paciente en tratamiento renal sustitutivo, hemodiálisis, diálisis peritoneal y trasplante renal; tratamiento paliativo de la uremia terminal. Esperamos que sirva de gran ayuda en el manejo multidisciplinar del paciente con ERC, a la vista de las recomendaciones más actualizadas.
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Affiliation(s)
| | - José L Górriz
- Sociedad Española de Nefrología (SEN), Barcelona, España
| | - Jordi Bover
- Sociedad Española de Nefrología (SEN), Barcelona, España
| | - Julián Segura-de la Morena
- Sociedad Española de Hipertensión Arterial-Liga Española para la Lucha contra la Hipertensión Arterial (SEH-LELHA), Madrid, España
| | - Jesús Cebollada
- Sociedad Española de Medicina Interna (SEMI), Madrid, España
| | - Javier Escalada
- Sociedad Española de Endocrinología y Nutrición (SEEN), Madrid, España
| | | | | | - Javier Gamarra
- Sociedad Española de Médicos Generalistas (AP) (SEMG), Madrid, España
| | - Silvia Gràcia
- Sociedad Española de Química Clínica (SEQC), Madrid, España
| | | | | | - Pilar Mazón
- Sociedad Española de Cardiología (SEC), Madrid, España
| | | | - Francisco Morales-Olivas
- Sociedad Española de Hipertensión Arterial-Liga Española para la Lucha contra la Hipertensión Arterial (SEH-LELHA), Madrid, España
| | | | | | - Ana de Santiago
- Sociedad Española de Medicina Rural y Generalista (AP) (SEMERGEN), Madrid, España
| | - Marta Sánchez-Celaya
- Sociedad Española de Medicina de Familia y Comunitaria (AP) (SEMFyC), Madrid, España
| | - Carmen Suárez
- Sociedad Española de Medicina Interna (SEMI), Madrid, España
| | - Salvador Tranche
- Sociedad Española de Medicina de Familia y Comunitaria (AP) (SEMFyC), Madrid, España
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Martínez-Castelao A, Górriz JL, Bover J, Segura-de la Morena J, Cebollada J, Escalada J, Esmatjes E, Fácila L, Gamarra J, Gràcia S, Hernández-Moreno J, Llisterri-Caro JL, Mazón P, Montañés R, Morales-Olivas F, Muñoz-Torres M, de Pablos-Velasco P, de Santiago A, Sánchez-Celaya M, Suárez C, Tranche S. [Consensus document for the detection and management of chronic kidney disease]. Semergen 2014; 40:441-59. [PMID: 25282133 DOI: 10.1016/j.semerg.2014.09.001] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2014] [Accepted: 06/20/2014] [Indexed: 02/07/2023]
Abstract
Chronic kidney disease (CKD) is an important global health problem, involving to 10% of the Spanish population, promoting high morbidity and mortality for the patient and an elevate consumption of the total health resources for the National Health System. This is a summary of an executive consensus document of ten scientific societies involved in the care of the renal patient, that actualizes the consensus document published in 2007. The central extended document can be consulted in the web page of each society. The aspects included in the document are: Concept, epidemiology and risk factors for CKD. Diagnostic criteria, evaluation and stages of CKD, albuminuria and glomerular filtration rate estimation. Progression factors for renal damage. Patient remission criteria. Follow-up and objectives of each speciality control. Nephrotoxicity prevention. Cardio-vascular damage detection. Diet, life-style and treatment attitudes: hypertension, dyslipidaemia, hyperglycemia, smoking, obesity, hyperuricemia, anemia, mineral and bone disorders. Multidisciplinary management for Primary Care, other specialities and Nephrology. Integrated management of CKD patient in haemodialysis, peritoneal dialysis and renal transplant patients. Management of the uremic patient in palliative care. We hope that this document may be of help for the multidisciplinary management of CKD patients by summarizing the most updated recommendations.
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Affiliation(s)
| | - José L Górriz
- Sociedad Española de Nefrología (SEN), Barcelona, España
| | - Jordi Bover
- Sociedad Española de Nefrología (SEN), Barcelona, España
| | - Julián Segura-de la Morena
- Sociedad Española de Hipertensión Arterial-Liga Española para la Lucha contra la Hipertensión Arterial (SEH-LELHA), Madrid, España
| | - Jesús Cebollada
- Sociedad Española de Medicina Interna (SEMI), Madrid, España
| | - Javier Escalada
- Sociedad Española de Endocrinología y Nutrición (SEEN), Madrid, España
| | | | | | - Javier Gamarra
- Sociedad Española de Médicos Generalistas (AP) (SEMG), Madrid, España
| | - Silvia Gràcia
- Sociedad Española de Química Clínica (SEQC), Madrid, España
| | | | | | - Pilar Mazón
- Sociedad Española de Cardiología (SEC), Madrid, España
| | | | - Francisco Morales-Olivas
- Sociedad Española de Hipertensión Arterial-Liga Española para la Lucha contra la Hipertensión Arterial (SEH-LELHA), Madrid, España
| | | | | | - Ana de Santiago
- Sociedad Española de Medicina Rural y Generalista (AP) (SEMERGEN), Madrid, España
| | - Marta Sánchez-Celaya
- Sociedad Española de Medicina de Familia y Comunitaria (AP) (SEMFyC), Madrid, España
| | - Carmen Suárez
- Sociedad Española de Medicina Interna (SEMI), Madrid, España
| | - Salvador Tranche
- Sociedad Española de Medicina de Familia y Comunitaria (AP) (SEMFyC), Madrid, España
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Documento de consenso para la detección y manejo de la enfermedad renal crónica. HIPERTENSION Y RIESGO VASCULAR 2014. [DOI: 10.1016/j.hipert.2014.06.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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9
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Rhee CM, Leung AM, Kovesdy CP, Lynch KE, Brent GA, Kalantar-Zadeh K. Updates on the management of diabetes in dialysis patients. Semin Dial 2014; 27:135-45. [PMID: 24588802 PMCID: PMC3960718 DOI: 10.1111/sdi.12198] [Citation(s) in RCA: 88] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
Diabetes mellitus is the leading cause of end-stage renal disease (ESRD) in the U.S. and many countries globally. The role of improved glycemic control in ameliorating the exceedingly high mortality risk of diabetic dialysis patients is unclear. The treatment of diabetes in ESRD patients is challenging, given changes in glucose homeostasis, the unclear accuracy of glycemic control metrics, and the altered pharmacokinetics of glucose-lowering drugs by kidney dysfunction, the uremic milieu, and dialysis therapy. Up to one-third of diabetic dialysis patients may experience spontaneous resolution of hyperglycemia with hemoglobin A1c (HbA1c) levels <6%, a phenomenon known as "Burnt-Out Diabetes," which remains with unclear biologic plausibility and undetermined clinical implications. Conventional methods of glycemic control assessment are confounded by the laboratory abnormalities and comorbidities associated with ESRD. Similar to more recent approaches in the general population, there is concern that glucose normalization may be harmful in ESRD patients. There is uncertainty surrounding the optimal glycemic target in this population, although recent epidemiologic data suggest that HbA1c ranges of 6% to 8%, as well as 7% to 9%, are associated with increased survival rates among diabetic dialysis patients. Lastly, many glucose-lowering drugs and their active metabolites are renally metabolized and excreted, and hence, require dose adjustment or avoidance in dialysis patients.
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Affiliation(s)
- Connie M. Rhee
- Harold Simmons Center for Kidney Disease Research and Epidemiology, Division of Nephrology and Hypertension, University of California Irvine, Orange, California
| | - Angela M. Leung
- Division of Endocrinology, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, California
| | - Csaba P. Kovesdy
- Division of Nephrology, Memphis Veterans Affairs Medical Center, Memphis Tennessee
- Division of Nephrology, University of Tennessee Health Science Center, Memphis, Tennessee
| | - Katherine E. Lynch
- Division of Nephrology, Beth Israel Deaconess Medical Center, Boston, Massachusetts
| | - Gregory A. Brent
- Division of Endocrinology, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, California
| | - Kamyar Kalantar-Zadeh
- Harold Simmons Center for Kidney Disease Research and Epidemiology, Division of Nephrology and Hypertension, University of California Irvine, Orange, California
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Chopra A, Rawat S, Bhalla V, Suri CR. Point-of-Care Amperometric Testing of Diabetic Marker (HbA1c) Using Specific Electroactive Antibodies. ELECTROANAL 2014. [DOI: 10.1002/elan.201300646] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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Gómez-Huelgas R, Martínez-Castelao A, Artola S, Górriz JL, Menéndez E. [Treatment of type 2 diabetes mellitus in patients with chronic kidney disease. Grupo de Trabajo para el Documento de Consenso sobre el tratamiento de la diabetes tipo 2 en el paciente con enfermedad renal crónica]. Med Clin (Barc) 2013; 142:85.e1-10. [PMID: 24268912 DOI: 10.1016/j.medcli.2013.10.011] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2013] [Revised: 10/21/2013] [Accepted: 10/24/2013] [Indexed: 02/06/2023]
Abstract
Chronic kidney disease (CKD) and type 2 diabetes mellitus (T2DM) are highly prevalent chronic diseases, which represent an important public health problem and require a multidisciplinary management. T2DM is the main cause of CKD and it also causes a significant comorbidity with regard to non-diabetic nephropathy. Patients with diabetes and kidney disease represent a special risk group as they have higher morbi-mortality as well as higher risk of hypoglycemia than diabetic individuals with a normal kidney function. Treatment of T2DM in patients with CKD is controversial because of the scarcity of available evidence. The current consensus report aims to ease the appropriate selection and dosage of antidiabetic treatments as well as the establishment of safety objectives of glycemic control in patients with CKD.
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Affiliation(s)
| | - Alberto Martínez-Castelao
- Sociedad Española de Nefrología (SEN), Grupo Español de Estudio de la Nefropatía Diabética (GEENDIAB), España
| | - Sara Artola
- Red de Grupos de Estudio de la Diabetes en Atención Primaria (redGDPS), España
| | - José Luis Górriz
- Sociedad Española de Nefrología (SEN), Grupo Español de Estudio de la Nefropatía Diabética (GEENDIAB), España
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Sharma P, Chopra A, Chaudhary S, Suri CR. Bio-nanomechanical Detection of Diabetic Marker HbA1c. BIONANOSCIENCE 2012. [DOI: 10.1007/s12668-012-0055-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Wangoo N, Kaushal J, Bhasin KK, Mehta SK, Suri CR. Zeta potential based colorimetric immunoassay for the direct detection of diabetic marker HbA1c using gold nanoprobes. Chem Commun (Camb) 2010; 46:5755-7. [DOI: 10.1039/c0cc00224k] [Citation(s) in RCA: 57] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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Přibyl J, Skládal P. Quartz crystal biosensor for detection of sugars and glycated hemoglobin. Anal Chim Acta 2005. [DOI: 10.1016/j.aca.2004.08.059] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Smoum R, Srebnik M. Boronated saccharides: potential applications. CONTEMPORARY ASPECTS OF BORON: CHEMISTRY AND BIOLOGICAL APPLICATIONS 2005. [DOI: 10.1016/s0169-3158(06)80008-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
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Abstract
Nonenzymatic glycosylation takes place in all proteins with a free-reacting lysine or valine in the presence of glucose. The formation of glycosylated plasma albumin, hemoglobin (Hb A1c), and skin collagen provides a diagnostic index of short- to long-term time-concentration of glucose in vivo. A wide range of assay methods are available, with affinity chromatographic, isoelectric focusing, and spectrophotometric methods providing the best accuracy and versatility. Glycosylated hemoglobin assays indicate glucose pressure over the previous 2 to 3 months and are of diagnostic value in general diabetic control, while glycosylated plasma albumin determinations are preferable in acute episodes in the life of a diabetic (e.g., pregnancy, infection, stress, trauma, surgery), since they provide an overview of changing blood glucose values of the previous 2 to 4 weeks. Glycosylated collagen estimations reflect tissue aging and are relevant in healing processes. Glycosylation alters the biologic activity of proteins, and these may relate to the manifold complications concomitant on the lifelong elevation of blood and tissue glucose in the diabetic (C6a). Assays for glycosylated hemoglobin have been routinely performed in clinical chemistry laboratories for a decade, and convenient determination for other nonenzymatically glycosylated proteins is proceeding apace.
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Abstract
Glycosylated haemoglobin (GHb) was measured in 71 patients with stable chronic renal failure by the thiobarbituric acid (TBA) reaction and by agar gel electrophoresis. Nineteen patients were diabetic. Of the non-diabetics, 22 were treated conservatively (including 8 children), 15 by maintenance haemodialysis, and 15 by continuous ambulatory peritoneal dialysis. GHb measured by both methods correlated with postprandial blood glucose levels. There was a significant discrepancy between the two methods only in patients with serum urea concentrations greater than 30 mmol/l, mean +/- SD, (6.8 +/- 2.6% vs 8.2 +/- 2.5% for TBA and electrophoresis, respectively). This difference, delta GHb, correlated with serum urea, serum creatinine, and serum bicarbonate, but after logistic regression of results from all 71 patients only serum urea was associated with delta GHb. Lower haemoglobin and GHb and high fetal haemoglobin concentrations in the haemodialysis group suggested increased haemolysis in these patients. Measurement of GHb by the TBA method and by agar gel electrophoresis remain useful indicators of hyperglycaemia in patients with mild, stable chronic renal failure.
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van Heyningen C, Hanid TK, Hopkinson I. Glycosylated haemoglobin by affinity chromatography in diabetic and non-diabetic children. Ann Clin Biochem 1986; 23 ( Pt 4):425-8. [PMID: 3767270 DOI: 10.1177/000456328602300407] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
We have made an evaluation of glycosylated haemoglobin measurements by affinity chromatography in a paediatric population. Age-related reference values for non-diabetic infants and children are reported. A poor correlation (r = 0.24) was found between glycosylated haemoglobin values in 26 insulin-dependent diabetic children and the paediatrician's independent assessment of clinical control.
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