Noer Sidqi Muhammadiy, Luki Herli Purniawan, Muhammad Hilmi Afthoni

Association Between HbA1c Level and Renal Function Markers in Patients with Diabetes Mellitus

Introduction

Association between hba1c level and renal function markers in patients with diabetes mellitus. Discover how HbA1c levels correlate with kidney function markers (creatinine, urea, microalbumin) in diabetes patients. Higher HbA1c links to worsening renal health.

Abstract

Background: Diabetes mellitus (DM) is a major contributor to kidney failure worldwide. Glycated haemoglobin (HbA1c) is widely recognised as a marker for glycemic regulation, yet its association with renal function decline is not fully clarified. Objective: This study investigates the association between HbA1c levels and renal function indicators, namely creatinine, urea, and microalbumin, in individuals with DM. Materials and Methods: A cross-sectional approach was utilised, analysing retrospective data collected from the medical records of DM patients participating in the Prolanis program in Bondowoso Regency during 2024. Correlation tests and linear regression were used to determine the relationship between HbA1c and the selected renal parameters, with a statistical significance threshold of p < 0.05. Results: Most patients exhibited HbA1c levels and renal parameters within normal limits. Nonetheless, a statistically significant positive correlation was identified between elevated HbA1c levels and increased concentrations of creatinine (p = 0.020), urea (p = 0.01), and microalbumin (p = 0.01). Conclusion: Higher HbA1c levels are associated with deteriorating kidney function among DM patients. However, HbA1c should not be solely relied upon as a standalone marker for renal impairment. Further investigations are necessary to elucidate the biological pathways involved and to evaluate the potential of HbA1c control in mitigating kidney disease progression.

Review

This study addresses a clinically pertinent question regarding the association between HbA1c levels and key renal function markers in patients with diabetes mellitus, a disease globally recognized for its significant contribution to kidney failure. The abstract clearly articulates the study's objective, which is to investigate this association using creatinine, urea, and microalbumin as indicators of renal function. The cross-sectional approach, utilizing retrospective data from a specific regional program, is outlined, along with the statistical methods employed. The findings, indicating a statistically significant positive correlation between higher HbA1c and elevated levels of all three renal markers, provide valuable evidence that reinforces the critical link between glycemic control and kidney health. A strength of this research lies in its clear presentation of a statistically significant positive correlation, demonstrating that elevated HbA1c levels are associated with increased concentrations of creatinine (p=0.020), urea (p=0.01), and microalbumin (p=0.01). This consistency across multiple renal markers strengthens the reported association. The use of data from the Prolanis program in Bondowoso Regency provides insights into a specific patient population, potentially informing local clinical practices. The methodology is appropriate for establishing correlations, and the acknowledgement that most patients initially exhibited parameters within normal limits, yet still showed these correlations, highlights the early associations between glycemic control and renal health. While providing valuable correlational insights, the cross-sectional design inherently precludes the inference of causality or the temporal sequence of events, a limitation the authors prudently acknowledge by cautioning against HbA1c's sole reliance as a marker for renal impairment. Future research would benefit significantly from longitudinal studies to track disease progression and explore the impact of HbA1c control interventions on renal outcomes over time. Further investigations into the underlying biological pathways and the replication of these findings in more diverse populations are also crucial to broaden generalizability and inform more comprehensive strategies for preventing and managing diabetic kidney disease. Despite these limitations, the study contributes to the body of evidence linking glycemic control to kidney function, underscoring the ongoing importance of managing HbA1c in DM patients.

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