만성신부전증 환자에서 Recombinant Human Erythropoietin 치료에 따른 혈액지표와 Hemoglobin A1c에 대한 연구 = Studies on Hematologic Parameters and HbA1c Level in Patients with Chronic Renal Failure after r-HuEpo Treatment

다국어 초록 (Multilingual Abstract)

Hemoglobin A1c is produced by a progressive, non-enzymatic reaction between glucose and hemoglobin within the erythrocytes. The HbA1c concentration is dependent on the plasma glucose level and the stage of development of the erythrocytes. Immature erythrocytes contain lower levels of glycosylated hemoglobin than mature erythrocytes. HbA1c level was decreased in short RBC life span. Therefore, HbA1c level is not only measure for assessment of moderate to long term glycemic status in diabetics, but also as a possible diagnostic parameter of anemia.
The aim of this study was to evaluate the HbA1c level in patients with chronic renal failure with anemia. HbA1c concentration, iron, ferritin, TIBC and hematologic parameters were measured before treatment and 1, 2 months after administration of recombinant human erythropoietin. The HbA1c concentration was measured by high performance liquid chromatography with cation exchange column (Pharmacia).
The results were as follows;
1. The mean of hemoglobin was 8.66 g/dL in the controls and 7.84 g/dL in the patients with chronic renal failure. The mean of hematocrit was 25.19 % in the controls and 23.14 % in the patients with chronic renal failure. The mean of MCV was 93.23 fL in the controls and 92.73 fL in the patients with chronic renal failure. The mean of MCH was 32.56 pg in the controls and 31.76 pg in the patients with chronic renal failure. The mean of HbA1c was 3.15 % in the controls and 2.95 % in the patients with chronic renal failure.
2. Hematologic parameters in the patients with chronic renal failure
1) The results of hemoglobins were 7.84 g/dL, 8.11 g/dL, 8.92 g/dL, the MCH were 31.76 pg, 32.87 pg, 33.20 pg, the results of MCV were 92.73 fL, 97.37 fL, 92.85 fL at before treatment and 1, 2 months after administration of r-HuEpo.
2) The results of hematocrits were 23.14 %, 23.73 %, 26.73 % at before treatment and 1, 2 months after administration of r-HuEpo.
3. Iron metabolism parameters in the patients with chronic renal failure
1) The results of iron test were 180.92 ㎍/dL, 137.79 ㎍/dL, 126.83 ㎍/dL at before treatment and 1, 2 months after administration of r-HuEpo.
2) The results of ferritin test were 1500.2 ng/ml, 1311.6 ng/ml, 1151.0 ng/ml at before treatment and 1, 2 months after administration of r-HuEpo.
3) The results of TIBC test were 282.17 ㎍/dL, 282.45 ㎍/dL, 278.83 ㎍/dL at before treatment and 1, 2 months after administration of r-HuEpo.
4. The results of HbA1c test were 2.95 %, 3.08 %, 3.18 % at before treatment and 1, 2 months after administration of r-HuEpo.
It is suggested that, in patients with chronic renal failure, evaluation of HbA1c in diabetics who have anemia with chronic renal failure should be consider possible hematologic parameters, and HbA1c level would be one of the marker of anemia status, but further studies are needed.