Читать книгу Recent Advances in Dialysis Therapy in Japan - Группа авторов - Страница 82

In the treatment of diabetes in patients with normal kidney function, the utility of HbA1c as a blood glucose control indicator has been established. However, the value of HbA1c tends to be low in dialysis patients. The reasons for this are, for example, that the life span of erythrocytes is shortened from the usual 120 days to about 60 days; blood loss can occur with hemodialysis therapy; and erythropoiesis-stimulating agents (ESAs) increase the proportion of immature red blood cells. Therefore, the lower resultant HbA1c low values may indicate better than actual blood glucose control. Based on the above, the JSDT guidelines [2] recommend using glycated albumin (GA), which is not affected by anemia, ESA dosage, or serum albumin value, as a better glycemic control index in hemodialysis patients, and recommends using HbA1c as a reference value [2, 6–8].