Glycosylated haemoglobin in chronic renal failure and after renal transplantation

Haemoglobin A₁ (HbA₁) was determined by ion-exchange chromatography in 37 normoglycaemic patients with chronic renal failure (CRF) and 26 with successful renal transplants. Blood glucose concentrations in patients with CRF were similar to those in controls, and there was a significant correlation between fasting blood glucose concentration and HbA₁ in these groups. HbA₁ in patients with CRF was, however, significantly lower than that in control subjects. Concentrations of HbA₁ in patients on haemodialysis, peritoneal dialysis, and those with steady state CRF prior to dialysis were not significantly different from each other. Whereas patients with successful renal transplants of greater than 3 months' duration had HbA₁ concentrations indistinguishable from controls, HbA ₁ in patients with transplants of shorter duration were significantly lower. These observations are suggestive of a shortened erythrocyte survival in CRF per se. Furthermore, these results indicate: (a) the inadequacy of HbA ₁ in monitoring the quality of diabetic control in patients with CRF, and (b) the absence of a specific effect of dialysis on HbA₁, and the restoration to normal of HbA₁ after successful renal transplantation.