Glycated Haemoglobin and Cardiovascular Complications in Non-Diabetic Haemodialysis Patients

Abstract

Background Cardiovascular disease is considered a common cause of morbidity and mortality in patients with end-stage renal disease on hemodialysis. Elevated levels of glycated hemoglobin (HbA1c) are associated with CVD in diabetic patients. However, there is lack of information regarding HbA1c and CVD risk in non-diabetic HD patients. This study aims to investigate the relationship between glycated hemoglobin levels and the risk for CVD in non-diabetic HD patients. Methods A prospective, cross-sectional study, which included 60 non-diabetic HD patients, 30 patients taking erythrocyte stimulating agents (ESA), and 30 patients with no-ESA. Each group was subdivided according to the presence or absence of CVD. All participants were subjected to full history taking, clinical examination, and laboratory investigations. Results Non-diabetic HD patients with CVD had higher mean ± SD HbA1c% (5.8 ± 0.2) and HOMA-IR (4.7 ± 0.7), than those with no-CVD (5.5 ± 0.3), and (4.2 ± 0.3) (p ˂0.05). Non-diabetic HD patients with CVD had longer dialysis duration, lower serum albumin, and HDL, but higher total cholesterol, CRP, Hb%, HbA1c%, and insulin resistance than those with no-CVD. HD patients who received higher doses of ESA therapy mean ± SD (80.8 ± 22.4) IU/Kg/Week had significantly lower HbA1c% (˂5%) than those who received lower doses (53.9 ± 23.8), who had HbA1c% (≥ 5.5–6%) (p˂0.05). There was a significantly positive correlation between the presence of CVD in HD patients and the HbA1c% levels (r = 0.492) (p˂0.05). Conclusion HbA1c can predict CVD in non-diabetic HD patients, and its lower levels are associated with lower CVD.