HbA1c AND LIPID PROFILE IN NONDIABETIC END STAGE RENAL DISEASE PATIENTS ON MAINTENANCE HEMODIALYSIS

Author: UMA MAHESWARI S, VIJAYASAMUNDEESWARI, JONES RONALD, EVANGELINE JONES

Category: Biochemistry

Abstract:

BACKGROUND : Glycated Haemoglobin (HbA1c) is a reliable marker of glycemic status over the preceding 2-3 months. Recent studies have shown impaired glycemic status in non diabetic End Stage Renal Disease (ESRD) patients who are on maintenance hemodialysis (MHD). Glycemic control, utilising serial measurement of HbA1c is generally recommended to limit end organ damage including cardiovascular morbidity and mortality. Chronic Kidney Disease (CKD) is known to be associated with major changes in the composition of plasma lipoproteins. This alteration may worsen in patients on Maintenance Haemodialysis (MHD).

AIMS AND OBJECTIVES : The study was aimed to assess the level of HbA1c and lipid profile in non diabetic ESRD patients on MHD and healthy controls.

MATERIALS AND METHODS : This was a case control study in which 40 non diabetic ESRD patients on maintenance hemodialysis were taken as cases and 40 apparently healthy individuals as controls. Fasting blood samples were analysed for glucose, HbA1c, Triglyceride, Total cholesterol, LDL and HDL. Statistical analysis was carried out by student's t-test.

RESULT : HbA1c level in ESRD patients on MHD was significantly higher when compared to healthy controls. (5.87 ± 0.46% versus 4.96 ± 0.3%; p<0.0001); Similar

statistical difference were observed in the levels of: Triglyceride (162.22 ±14.13 mg/dl versus 119.65±29.89

mg/dl; p<0.0001); LDL (95.58 ± 19.42 mg/dl versus 80.02

± 20.29 mg/dl; p<0.0008; HDL (29.35 ± 4.04 mg/dl versus 49.32 ± 7.47 mg/dl; p<0.0001).

CONCLUSION : The results indicate that non-diabetic ESRD patients undergoing MHD showed elevated HbA1c, Triglyceride and low HDL level than controls. This altered lipid pattern and dysglycemia may accelerate the process of atherosclerosis, a risk for CVD and also increases the morbidity and mortality in patients.

Keywords: non-diabetic, MHD , HbA1c, Triglyceride, low HDL level