We studied the influence of erythropoietin (EPO) treatment on hemoglobin Alc (HbAlc) levels under conditions which eliminate the effect of changes in the blood glucose concentration. HbAlc levels, blood glucose, hematocrit (Hct) and reticulocyte counts were serially measured every two weeks after starting or stopping EPOadministration in 15 non-diabetic hemodialysis patients. EPOtreatment significantly influenced HbAlc levels, and the more erythropoiesis fluctuated by changing the dose ofEPO, the more HbAlc levels changed, though there were no significant changes in blood glucose levels during the study period. The changes in HbAlc during the 2-week period correlated inversely with both the changes in Hct during the same 2 weeks and the reticulocyte counts at that time. Weconcluded that the change in Hct should be kept in mind when the HbAlc level is evaluated in EPO-treated patients and a formula should be proposed to correct HbAlc levels based on the change in Hct or the reticulocyte count. (Internal Medicine 37: 826-830, 1998)

Background and Objective The influence of glycemic control on cardiovascular (CV) complications or survival is not clear in diabetic patients with end-stage renal disease (ESRD

Application of the findings in this study to patient care may permit selection of an appropriate initial maintenance dosage to achieve target theophylline concentrations, thus enabling the clinician to achieve the desired therapeutic effect in very premature Japanese infants.

SUMMARY: We investigated to clarify the predialysis factors associated with prognosis in type 2 diabetic patients entering chronic dialysis. One hundred and twenty‐four type 2 diabetic patients who started chronic dialysis in our department between January 1992 and November 2000 were studied. the variables in the predialysis period and those at initiation of dialysis were collected and evaluated in association with prognosis after a mean follow up of 37 ± 23 months from initiation of dialysis by using Cox's proportional‐hazards model. the 1‐, 3‐, and 5‐year survival rates after initiating chronic dialysis were 92.7, 74.6, and 56.5%, respectively. During follow up, 40 patients died. Univariate analysis demonstrated that serum albumin (Alb) levels, haemoglobin A1c, and no preparation for permanent vascular or peritoneal access at initiation of dialysis were significantly associated with prognosis. In multivariate analysis, Alb levels (hazard ratio, 2.09, per decrease of 1 g/dL; confidence interval, 1.05–4.19), and age (1.54, per decrease of 10 years; 1.06–2.22) at initiation of dialysis remained significant predictors of mortality. In conclusion, Alb levels and age at initiation of dialysis are associated with prognosis in type 2 diabetic patients on chronic dialysis. It should be elucidated whether improvement of Alb levels at initiation of dialysis would have a favourable influence on survival after diabetic patients with renal failure are entered into chronic dialysis.

Low-density lipoprotein apheresis retards the progression ofmove a large amount of plasma lipid directly from pahyperlipidemic overt diabetic nephropathy. tients in a short time. If hyperlipidemia played an impor-Background. Hyperlipidemia has recently received attentant role in the progression of renal diseases, it should tion as being involved in the progression of diabetic nephropabe possible to improve renal injury by LDL-A. Some thy (DN). Low-density lipoprotein apheresis (LDL-A) can resuccessful clinical results were already reported for primove a large amount of plasma lipid directly from the patients in a short time. mary nephrotic syndrome caused by focal glomeruloscle-Methods. Fifteen type 2 diabetic patients with overt nerosis [4, 5]. LDL-A, however, has not yet been used in phropathy received LDL-A in two different manners: shortpatients with DN. In this study, we performed LDL-A term intensive therapy (SIT) for nine patients and long-term in hyperlipidemic overt DN patients to evaluate the efintermittent therapy (LIT) for six patients.fect of this therapy on the progression of DN.Results. The changes in the monthly decline rates of reciprocal serum creatinine (1/Cr) were Ϫ0.035 Ϯ 0.020 in the threemonth period before SIT, 0.047 Ϯ 0.041 during and until two METHODS weeks after SIT, and Ϫ0.035 Ϯ 0.015 after a period of two weeks from the therapy. The mean duration of LIT in six Patients patients was 8.2 Ϯ 7.4 months, and the mean monthly decline Fifteen type 2 diabetic patients (nine males and six rates of 1/Cr significantly decreased during the period of LIT as compared with the six-month period before the treatment. females, mean age 60.3 Ϯ 6.4) with nephropathy were Conclusion. LDL-A can retard the progression of overt DN,