Higher, Lower HbA1c Levels Associated With Worse Outcomes In CKD With Diabetes.

Higher, Lower HbA1c Levels Associated With Worse Outcomes In CKD With Diabetes.

MedPage Today  (11/29, Neale) reports, "Among patients with diabetes and stage 3 or 4 chronic kidney disease, glycated hemoglobin levels that are too low are associated with worse clinical outcomes, just as are levels that are too high," according to a study  in the Nov. 28 issue of Archives of Internal Medicine. "Higher glycated hemoglobin (HbA1c) levels at baseline were associated with greater risks of death, progression of kidney disease, new end-stage renal disease, cardiovascular events, and all-cause hospitalization (P<0.001 for all trends)." However, "for mortality in particular, an HbA1c level that was too low -- less than 6.5% -- also was associated with an elevated risk." An accompanying editorial  "called for randomized controlled trials to better inform the discussion about the best approaches for managing risk factors in patients with advanced kidney disease."