# Association between glycated albumin and sudden death in patients undergoing hemodialysis

## TL;DR

High glycated albumin levels are linked to sudden death in hemodialysis patients, even after adjusting for other factors.

## Contribution

This study identifies glycated albumin as a novel risk factor for sudden death in hemodialysis patients.

## Key findings

- Patients with the highest glycated albumin levels had a 5.4 times higher risk of sudden death.
- The association remained significant after adjusting for age, sex, albumin, CRP, and CTR.
- Sudden death cases were younger, more male, and had higher diabetes prevalence.

## Abstract

The frequency of sudden death and its risk factors in patients undergoing hemodialysis are unknown. This study was performed to examine the association between glycated albumin (GA) and sudden death in Japanese patients undergoing hemodialysis.

In total, 260 patients undergoing hemodialysis aged ≥18 years were retrospectively followed for a mean of 4.6 years. The patients’ serum GA levels were divided into tertiles, and the patients’ sex, age, albumin level, C-reactive protein (CRP) level, and cardiothoracic ratio (CTR) were selected as adjustment factors. A logistic regression model was used to calculate the odds ratio (OR) for the occurrence of sudden death by GA level.

Ninety-one patients died during follow-up. Of the 91 deaths, 23 (25.2%) were defined as sudden deaths. Compared with non-sudden death cases, sudden death cases were significantly younger (p = 0.002) and had a higher proportion of men (p = 0.03), a higher proportion of diabetes (p = 0.008), and higher GA levels (p = 0.023). Compared with patients with the lowest GA levels (<15.2%), those with the highest GA levels (≥18.5%) had a sex- and age-adjusted OR for sudden death of 5.40 [95% confidence interval (CI): 1.35–21.85]. After adjusting for the albumin level, CRP level, and CTR in addition to sex and age, the OR for sudden death of patients with the highest GA levels increased to 6.80 (95%CI: 1.64–28.08); the relationship did not change.

Serum GA levels were significantly associated with sudden death in patients undergoing hemodialysis.

The online version contains supplementary material available at 10.1007/s10157-024-02475-w.