Association of Glycated Haemoglobin (HbA1c) Levels with Serum Creatitine and Urea in Renal Patients thet Attended Parirenyatwa Hospital, Harare in 2023

Abstract

Diabetes mellitus poses a significant global health burden, and chronic kidney disease stands as a major and concerning complication. This study investigated the potential association between glycemic control, as measured by hemoglobin A1c (HbA1c), and the functional state of the kidneys in diabetic patients admitted to the renal ward of Parirenyatwa Hospital, Zimbabwe. Employing a retrospective cross-sectional design, the study analyzed data from 106 diabetic patients admitted between January and December 2023. A stratified random sampling technique ensured participant representativeness by selecting individuals across three distinct age groups (18-30 years, 30-50 years, and 50+ years). Data included the HbA1c levels, which serve as a crucial indicator of long-term blood sugar control. Additionally, serum creatinine and urea levels were retrieved, as these markers provide valuable insights into kidney function. By analyzing these parameters, the study aimed to identify any potential correlations that might exist between glycemic control and renal health. The mean HbA1c results for the strata from youngest to oldest were 7.2%, 7.5% and 8.1% respectively. For serum creatinine the mean was 442 µmol/L, 534 µmol/L and 621 µmol/L respectively whilst the mean urea results are 2.86 mmol/L, 3.39 mmol/L and 4.01 mmol/L respectively. These statistical tests revealed a positive correlation between HbA1c levels and both serum creatinine and urea levels. The results indicated that patients with higher HbA1c, signifying poorer glycemic control, tended to have higher levels of creatinine and urea in their blood, suggesting compromised kidney function. Analysis revealed that the oldest age group (50+ years) displayed significantly higher HbA1c and creatinine levels compared to younger diabetic patients. This suggests that older individuals with diabetes might be at a greater risk for experiencing both poor glycemic control and impaired kidney function. The retrospective nature of the design relies on existing data within medical records, potentially introducing unforeseen biases. Additionally, the sample size of 106 participants might limit the generalizability of the findings to the entire population of diabetic patients in Zimbabwe. Despite these limitations, the study offers valuable preliminary data on the observed positive correlation between HbA1c and renal function markers in Zimbabwean diabetics. The results highlight the importance of effective glycemic control strategies in managing diabetes to potentially reduce the risk of developing CKD. Further research utilizing a larger, prospective cohort design is recommended to establish causal relationships and explore additional contributing factors influencing CKD development in this specific population.