Glycemic Control and Mortality in Hemodialysis Patients

The prevalence of diabetes is high among patients who undergo hemodialysis. To determine whether glycemic control is associated with mortality in dialysis patients, Canadian researchers conducted a retrospective cohort study of 1484 adults (median age, 66) who started hemodialysis in northern Alberta between 2001 and 2007.

In nearly half the patients, diabetic nephropathy was the underlying cause of renal failure; another 13% of patients (who were undergoing dialysis for nondiabetic renal disease) also had diabetes. During median follow-up of 1.5 years, 43% of patients died. In multivariable analyses, neither hemoglobin A_1c level nor the average of multiple glucose levels (measured around the time when dialysis was initiated) was associated …