Int J Med Sci 2016; 13(5):395-402. doi:10.7150/ijms.14259

Research Paper

Glycated Albumin Predicts Long-term Survival in Patients Undergoing Hemodialysis

Chien-Lin Lu1,2,*, Wen-Ya Ma2, Yuh-Feng Lin1,3, Jia-Fwu Shyu4, Yuan-Hung Wang1,5, Yueh-Min Liu2, Chia-Chao Wu6,*, Kuo-Cheng Lu2,6 ✉

1. Graduate Institute of Clinical Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan.
2. Department of Medicine, Cardinal Tien Hospital, School of Medicine, Fu Jen Catholic University, New Taipei City, Taiwan.
3. Division of Nephrology, Department of Internal Medicine, Shuang Ho Hospital, Taipei Medical University, Taiwan
4. Department of Biology and Anatomy, National Defense Medical Center, Taipei, Taiwan
5. Department of Medical Research, Shuang Ho Hospital, New Taipei City, Taiwan
6. Division of Nephrology, Department of Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan.
* These authors have contributed equally to this work.

This is an open access article distributed under the terms of the Creative Commons Attribution (CC BY-NC) License. See for full terms and conditions.
Lu CL, Ma WY, Lin YF, Shyu JF, Wang YH, Liu YM, Wu CC, Lu KC. Glycated Albumin Predicts Long-term Survival in Patients Undergoing Hemodialysis. Int J Med Sci 2016; 13(5):395-402. doi:10.7150/ijms.14259. Available from

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Background: In patients with advanced renal dysfunction undergoing maintenance hemodialysis, glycated albumin (GA) levels may be more representative of blood glucose levels than hemoglobin A1C levels. The aim of this study was to determine the predictive power of GA levels on long-term survival in hemodialysis patients.

Methods: A total of 176 patients with a mean age of 68.2 years were enrolled. The median duration of follow-up was 51.0 months. Receiver-operating characteristic curve analysis was utilized to determine the optimal cutoff value. We examined the cumulative survival rate by Kaplan-Meier estimates and the influence of known survival factors with the multivariate Cox proportional-hazard regression model.

Results: In the whole patient group, cumulative survival in the low GA group was better than in the high GA group (p=0.030), with more prominence in those aged <70 years (p=0.029). In subgroup analysis, both diabetic (DM) and non-DM patients with low GA had a better cumulative survival compared with those with high GA. The risk of mortality increased by 3.0% for each 1% increase in serum GA level in all patients undergoing hemodialysis.

Conclusions: In addition to serving as a glycemic control marker, GA levels may be useful for evaluating the risk of death in both DM and non-DM patients on hemodialysis.

Keywords: Glycated albumin, hemodialysis, mortality