Please use this identifier to cite or link to this item: http://ir.swu.ac.th/jspui/handle/123456789/12453
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dc.contributor.authorLimkunakul C.
dc.contributor.authorde Boer I.H.
dc.contributor.authorKestenbaum B.R.
dc.contributor.authorHimmelfarb J.
dc.contributor.authorIkizler T.A.
dc.contributor.authorRobinson-Cohen C.
dc.date.accessioned2021-04-05T03:03:31Z-
dc.date.available2021-04-05T03:03:31Z-
dc.date.issued2019
dc.identifier.issn10568727
dc.identifier.other2-s2.0-85061702864
dc.identifier.urihttps://www.scopus.com/inward/record.uri?eid=2-s2.0-85061702864&doi=10.1016%2fj.jdiacomp.2018.12.010&partnerID=40&md5=f3e131530c27e2a133454b0f0a02dd01
dc.identifier.urihttp://ir.swu.ac.th/jspui/handle/123456789/12453-
dc.description.abstractContext: Diabetic kidney disease (DKD) is the leading cause of end stage kidney disease (ESKD) and is associated with a considerably shortened lifespan. While glucose-lowering therapy targeting glycated hemoglobin (HbA1c) <7% is proven to reduce the risk of developing DKD, its effects on complications of DKD are unclear. Objective: We examined the associations of HbA1c with risks of progression to ESKD and death within a clinic-based study of CKD. We hypothesized that higher HbA1c concentrations would be associated with increased risks of ESKD and death. Design and setting: We studied 618 participants from the Seattle Kidney Study (mean eGFR 42 ml/min), 308 of whom had diabetes, and tested associations of baseline HbA1c with time to a composite outcome of initiation of renal replacement therapy or death. Results: During a median follow-up of 4.2 years, there were 343 instances of the composite outcome (11.5 per 100 person-years). Among participants with diabetes, in both crude and adjusted analyses, higher HbA1c levels (examined continuously or categorically) were not associated with the risk of the composite outcome (HR (95% CI): 0.99 (0.88, 1.10) per 1% additional HbA1c, p = 0.79). HbA1c was not associated with ESKD or mortality when the outcomes were examined separately, nor when stratified between insulin users and non-users. Conclusion: In a referred population of established DKD, higher HbA1c was not associated with higher risk of ESKD or death. These data support current recommendations to be conservative with glycemic control among patients with advanced diabetes complications, such as CKD. © 2019 Elsevier Inc.
dc.subjecthemoglobin A1c
dc.subjectglycosylated hemoglobin
dc.subjectadult
dc.subjectArticle
dc.subjectchronic kidney failure
dc.subjectcohort analysis
dc.subjectdiabetic nephropathy
dc.subjectdisease association
dc.subjectend stage renal disease
dc.subjectfemale
dc.subjectfollow up
dc.subjecthuman
dc.subjectmajor clinical study
dc.subjectmale
dc.subjectmortality
dc.subjectoutcome assessment
dc.subjectpriority journal
dc.subjectprospective study
dc.subjectrenal replacement therapy
dc.subjectrisk assessment
dc.subjectaged
dc.subjectblood
dc.subjectchronic kidney failure
dc.subjectdiabetes mellitus
dc.subjectdiabetic nephropathy
dc.subjectdisease exacerbation
dc.subjectepidemiology
dc.subjectglomerulus filtration rate
dc.subjectmetabolism
dc.subjectmiddle aged
dc.subjectvery elderly
dc.subjectWashington
dc.subjectAdult
dc.subjectAged
dc.subjectAged, 80 and over
dc.subjectDiabetes Mellitus
dc.subjectDiabetic Nephropathies
dc.subjectDisease Progression
dc.subjectFemale
dc.subjectGlomerular Filtration Rate
dc.subjectGlycated Hemoglobin A
dc.subjectHumans
dc.subjectKidney Failure, Chronic
dc.subjectMale
dc.subjectMiddle Aged
dc.subjectRenal Insufficiency, Chronic
dc.subjectWashington
dc.titleThe association of glycated hemoglobin with mortality and ESKD among persons with diabetes and chronic kidney disease
dc.typeArticle
dc.rights.holderScopus
dc.identifier.bibliograpycitationJournal of Diabetes and its Complications. Vol 33, No.4 (2019), p.296-301
dc.identifier.doi10.1016/j.jdiacomp.2018.12.010
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