末期腎臟病病人糖化血色素判讀

Hemoglobin A1c in the End-Stage Renal Disease Population

郭秋煌(Chiu-Huang Kuo) ； 徐邦治(Bang-Gee Hsu)

《腎臟與透析》 28卷2期 (2016/06) Pp. 63-66

https://doi.org/10.6340/KD.2016.28(2).03

摘要

糖化血色素是血糖控制的關鍵指標，但對尿毒症患者而言，糖化血色素數值易偏低，而低估血糖控制狀況。本文介紹從紅血球生成、糖化、和紅血球破壞等方面，來探討紅血球生成素使用、缺鐵性貧血、紅血球壽命等如何影響糖化血色素數值，進一步避免判讀失準。也提到新型的血糖指標糖化白蛋白，更適用於末期腎臟病患者，也可據以判斷預後。

關鍵字

末期腎臟病 ； 糖尿病 ； 糖化血色素

並列摘要

Hemoglobin A1c had been used as an indicator for long term glycemic control and prognosis prediction in diabetes patients. However, there are many factors that would interfere with hemoglobin A1c level in uremic population. In most condition, the hemoglobin level was underestimated in this group. Here we reviewed different mechanisms related to hemoglobin A1c concentration: erythropoiesis, RBC glycation and destruction. We also described specific conditions of end-stage renal disease patients, including erythropoiesis stimulating agent use, iron deficiency, and altered hemoglobin lifespan. Besides, we further discussed another new indicator, glycated albumin, for better long term glycemic monitor and prognosis prediction.

並列關鍵字

end-stage renal disease ； diabetes mellitus ； glycated hemoglobin