Is hbA1c a good marker of blood sugar control in a person with progressive kidney failure?
Although hemoglobin A1c is a sufficient marker of blood sugar control in a patient with earlier stages of kidney disease who does not yet require dialysis, this parameter has limited utility in patients with stage 5 disease.
Studies suggest little correlation between average blood glucose level and hemoglobin A1c with clinical outcomes in late-stage CKD due to nonenzymatic glycosylation of hemoglobin in the uremic serum and shortened red blood cell survival.
Multiple other potential markers have been studied, and glycosylated albumin may be a good alternative for assessment of glycemic control.
