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Article 2026 · 0 citations

Glycaemic control and complications in haemodialysis patients: the TURK-HEMODIAB Study

Gungor, Ozkan, Korucu, Berfu, Oguz, Ebru Gok, Eren, Necmi, Ural, Zeynep, Dheir, Hamad, Tatar, Erhan, Inci, Ayca, Kocyigit, Ismail, Aydin, Zeki, Ulutas, Ozkan, Kara, Ekrem, Altunoren, Orcun, Yilmaz, Zulfukar, Sevinc, Mustafa, Sevinc, Can, Surardamar, Atalay, Islam, Mahmud, Akgol, Cuneyt, Tonbul, Halil Zeki, Ozler, Tuba Elif, Guney, Ibrahim, Cevher, Simal Koksal, Uysal, Cihan, Guzel, Fatma Betul, Mutluay, Ruya, Ercan, Zafer, Sirali, Semahat Karahisar, Cankaya, Emre, Onan, Engin, Candan, Ferhan, Eroglu, Eray, Tezcan, Neslihan, Polat, Mehmet, Huzmeli, Can, Ozkurt, Sultan, Akagun, Tulin, Alp, Pinar, Ozelsancak, Ruya, Yurteri, Gurkan, Tanrisev, Mehmet, Ilter, Ali, Guvercin, Beyhan, Demir, Mehmet Emin, Tomar, Ozdem Kavraz, Azak, Alper, Turgut, Faruk Hilmi, Tuncay, Mehmet, Akdam, Hakan, Selen, Tamer, Yilmaz, Fatih, Danis, Ramazan, Eyupoglu, Sahin, Kumru, Gizem, Demir, Simge Bardak, Alagoz, Selma, Uzun, Sami, Ozdemir, Orhan, Adibelli, Zelal, Ulu, Ramazan, Murt, Ahmet, Dolarslan, Murside Esra, Bal, Ayse Zeynep, Ayar, Yavuz, Sensoy, Nazife Nur Ozer, Sezen, Mehmet, Sahutoglu, Tuncay, Kara, Ali Veysel, Turkmen, Ercan, Kayabasi, Hasan, Gorgulu, Numan, Hur, Ender, Yucel, Fatma Sibel Kocak, Eren, Zehra, Sahin, Garip, Kasapoglu, Umut, Biyik, Zeynep, Koyuncu, Sumeyra, Aydin, Mehmet Fetullah, Yildirim, Tolga, Kuzgun, Gulsah Sasak, Ustundag, Sedat, Celik, Abdulkadir, Akcali, Esra, Usalan, Ozlem, Kaya, Bulent, Altiparmak, Mehmet Riza, Tugcu, Murat, Olmaz, Refik, Erkus, Edip, Soypacaci, Zeki, Zorba, Belma Gokcen, Yavuz, Demet, Oztop, Kenan Evren, Ogutmen, Melike Betul, Harmankaya, Ozlem, Taymez, Dilek Guven, Kaptanogullari, Hakan, Magden, Kemal, Seyrek, Neslihan, Berktas, Haci Bayram, Erdem, Mehmet, Ozturk, Savas, Arikan, Izzet Hakki, Kutlay, Sim, Altun, Bulent, Ates, Kenan, Arici, Mustafa

Abstract

Background The most common cause of end-stage kidney disease is diabetes mellitus (DM). The most commonly used renal replacement therapy in Turkey and in many countries around the world is haemodialysis (HD). Glycaemia control is important in these populations. In this study we aimed to screen for glycaemic control and complications in a large population of diabetic HD patients in Turkey. Methods A total of 16 043 patients were screened in 253 dialysis centres in Turkey and 5038 diabetic HD patients were included in the study. At participating centres, patients' diabetes history, complications, medications, haemoglobin A1c (HbA1c) and other laboratory data were reviewed and recorded by nephrologists. Results The average age of the patients was 64.0 +/- 11.2 years and 56% were male. The mean HbA1c was 7.4 +/- 1.5%. Patients were divided into three groups according to the HbA1c level (<6.5%, 6.5-8% and >8%). As the HbA1c levels increased, the mean systolic blood pressure and diastolic blood pressure increased significantly. In addition, as the HbA1c levels increased, the number of patients with coronary artery disease, patients undergoing coronary artery bypass graft surgery and the rate of patients with diabetic retinopathy and vision loss increased. Diabetic foot disease and amputation rates were also higher in the group with poor glycaemic control. The number of patients using intensive or mixed insulin was also higher in the group with high HbA1c levels. In ordinal logistic regression analysis, age significantly decreased and higher body mass index slightly increased the risk of a higher HbA1c. Also, the need for a diabetic diet was greater in those with high HbA1c levels. Conclusion Our study highlights that the target values for diabetic HD patients in Turkey are partially compatible with the 2022 Kidney Disease: Improving Global Outcomes guidelines for diabetes management. Nevertheless, more effort and teamwork are needed to improve patient outcomes.

Keywords
complication diabetic glycaemic control HbA1c haemodialysis KIDNEY-DISEASE DIABETIC-PATIENTS RISK EPIDEMIOLOGY MORTALITY HBA1C
WoS Categories
Urology & Nephrology
Sustainable Development Goals
Citation
Journal
CLINICAL KIDNEY JOURNAL
Year
2026
Volume
19
Issue
1
ISSN
2048-8505
eISSN
2048-8513
DOI
10.1093/ckj/sfaf120
WoS UID
WOS:001660878300001
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