Haemoglobin glycation index novel risk factor for CKD in general population

Chronic kidney disease, defined as dipstick proteinuria or estimated glomerular rate (eGFR) < 60 ml/min/1.73 m2, is a worldwide health problem. Treatment of established CKD is difficult and reversibility of the diseased kidney to the normal state is questionable. Therefore, CKD prevention is of paramount importance. However, it is not an easy task because a sizable number of CKD patients develop it with elevated plasma glucose and/or mild hypertension both of which are asymptomatic at an early stage. Risk factor (s) for CKD is mostly unknown in apparently healthy populations.

Recent literature has shown that HGI is significantly related to CKD and cardiovascular diseases in patients with prediabetes and diabetes. Toru Aizawa, Diabetes Center, Aizawa Hospital, Matsumoto, Japan, and colleagues aimed to reveal the impact of HGI as a predictor for incident CKD in the general population.

For the patients, the researchers used data from CKD-free health examinees (N = 23,467, 4.1% of them had diabetes) to assess the impact of HGI on incident CKD and followed up for the mean of 5.1 years. Cox proportional hazards model was employed with multivariate adjustment for systolic blood pressure, age, fasting plasma glucose, eGFR, log[alanine aminotransferase], log[triglycerides], body mass index, smoking, sex, platelets count, and high-density-lipoprotein-cholesterol. Elevated level of HGI in CKD patients was ascertained after propensity score matching of another group of health examinees (N = 2580, 7.6% of them had diabetes).