Evidence map›Paper›PMID 33099507›Full record

ArticleBMJ open diabetes research & care2020

Glycated albumin and hemoglobin A1c levels and cause-specific mortality by patients' conditions among hemodialysis patients with diabetes: a 3-year nationwide cohort study.

Junichi Hoshino, Masanori Abe, Takayuki Hamano, Takeshi Hasegawa, Atsushi Wada, Yoshifumi Ubara, Kenmei Takaichi, Shigeru Nakai, Ikuto Masakane, Kosaku Nitta

Open access · goldAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in BMJ open diabetes research & care, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers.

0numbers the graph read from it
0cells of the map it votes in
6citing papers in PubMed
1.0field-weighted citation impact, top 25% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

6 citing papers in PubMed, 14 citations in OpenAlex.

  1. Article
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  4. Glycated Albumin and Adverse Clinical Outcomes in Patients With CKD: A Prospective Cohort Study.American journal of kidney diseases : the official journal of the National Kidney Foundation · 2024
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors at 5 institutions in 3 countries.

Junichi HoshinoNephrology Center, Toranomon Hospital, Tokyo, Japan jhoshino-ind@umin.ac.jp.ORCID 0000-0002-0444-101X
Masanori AbeCommittee of Renal Data Registry, Japanese Society for Dialysis Therapy, Tokyo, Japan.
Takayuki HamanoCommittee of Renal Data Registry, Japanese Society for Dialysis Therapy, Tokyo, Japan.
Takeshi HasegawaCommittee of Renal Data Registry, Japanese Society for Dialysis Therapy, Tokyo, Japan.
Atsushi WadaCommittee of Renal Data Registry, Japanese Society for Dialysis Therapy, Tokyo, Japan.
Yoshifumi UbaraNephrology Center, Toranomon Hospital, Tokyo, Japan.
Kenmei TakaichiNephrology Center, Toranomon Hospital, Tokyo, Japan.
Shigeru NakaiCommittee of Renal Data Registry, Japanese Society for Dialysis Therapy, Tokyo, Japan.
Ikuto MasakaneCommittee of Renal Data Registry, Japanese Society for Dialysis Therapy, Tokyo, Japan.
Kosaku NittaCommittee of Renal Data Registry, Japanese Society for Dialysis Therapy, Tokyo, Japan.
Renal Association · GBToranomon Hospital · JPFujita Health University · JPNihon University · JPShowa University · JP

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introductionDifferences in mortality and cause-specific mortality rates according to glycated albumin (GA) and hemoglobin A1c (HbA1c) levels among dialysis patients with diabetes based on hypoglycemic agent use and malnutrition status remain unclear. Here, we examine these associations using a nationwide cohort. RESEARCH DESIGN AND

methodsWe examined 40 417 dialysis patients with diabetes who met our inclusion criteria (female, 30.8%; mean age, 67.3±11.2 years; mean dialysis duration, 5.4±4.6 years). The Global Leadership Initiative on Malnutrition criteria were used to assess malnutrition. Adjusted HRs and 95% confidence limits were calculated for 3-year mortality after adjustment for 18 potential confounders. HRs and subdistribution HRs were used to explore cause-specific mortality.

resultsWe found a linear association between 3-year mortality and GA levels only in patients with GA ≥18% and not in patients with low GA levels, with a U-shaped association between HbA1c levels and the lowest morality at an HbA1c 6.0%-6.3%. This association differed based on patient conditions and hypoglycemic agent use. If patients using hypoglycemic agents were malnourished, mortality was increased with GA ≥24% and HbA1c ≥8%. In addition, patients with GA ≥22% and HbA1c ≥7.6% had significantly higher infectious or cardiovascular mortality rates. On the other hand, an inverse association was found between GA or HbA1c levels and cancer mortality. Patients with GA ≤15.8% had a higher risk of cancer mortality, especially those not using hypoglycemic agents (HR 1.63 (1.00-2.66)).

conclusionsTarget GA and HbA1c levels in dialysis patients may differ according to hypoglycemic agent use, nutritional status, and the presence of cancer. The levels may be higher in malnourished patients than in other patients, and a very low GA level in dialysis patients not taking hypoglycemic agents may be associated with a risk of cancer. TRIAL REGISTRATION NUMBER: UMIN000018641.

Indexed as

Diabetes Mellitus, Type 2AgedCause of DeathCohort StudiesFemaleGlycated HemoglobinGlycated Serum AlbuminGlycation End Products, AdvancedHumansMiddle AgedRenal DialysisSerum AlbuminGlycated HemoglobinGlycated Serum AlbuminGlycation End Products, AdvancedSerum Albumindialysishypoglycemic agentsmalnutritionmortality

Identifiers

PMID33099507
PMCPMC7590349
OpenAlexW3093833738

What OpenQuestion holds

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LicenceCC BY-NC
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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.