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DOPPS Examines Hemoglobin A1C Levels and Mortality in the ESRD Population
In the multinational Dialysis Outcomes and Practice Patterns (DOPPS) study, we present new analyses evaluating the relationship between blood sugar control in patients on dialysis with diabetes and risk of death.
This research demonstrates the importance of measuring A1c levels, a marker of blood sugar control among patients on dialysis who also have diabetes mellitus. In this analysis, the relationship between average A1c levels and risk of death was U-shaped, so that patients with low blood sugar levels and high blood sugar levels were found to be at increased risk. The study findings further suggest that target A1c levels (target blood sugar control) may be higher among patients on dialysis as compared to the general population since mortality risk appears to be lowest at A1c levels of between 6-9%.
According to the lead author of this study, Sylvia Ramirez, MD, MPH, MBA, "Management of patients with diabetes and ESRD is particularly challenging. Current clinical practice guidelines for dialysis patients are based on studies in the general population with diabetes. This study contributes to our knowledge regarding the importance of glycemic control in the ESRD population, and yet, informs clinical practice regarding potential differences in target Hemoglobin A1c levels in the dialysis population."
The DOPPS is a prospective cohort study of hemodialysis practices based on the collection of observational longitudinal data for a random sample of patients from a representative and random sample of units in 12 countries. The study seeks to determine which dialysis practices are associated with the best patient outcomes; its primary goals are improving patient longevity and quality of life. With over 100 peer-reviewed publications, the DOPPS continues to provide findings that are relevant for patients and practicing clinicians. Since 1996, data collection has yielded detailed information on more than 38,000 patients in over 900 dialysis facilities.
The DOPPS is supported by research grants from Amgen (since 1996), Kyowa Hakko Kirin (since 1999, in Japan), Genzyme (since 2009), Abbott (since 2009), and Baxter (since 2011) without restrictions on publications.
To view PowerPoint slides on this research presented at the ASN Kidney Week press briefing, please click here .
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Inquiries to:
Katherine Pearson
Communications Coordinator
Arbor Research Collaborative for Health
(734) 369-9639
communications@ArborResearch.org
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