Objectives: The aim of this study is to investigate the interference of carbamylated haemoglobin (cHb) to haemoglobin A1c (HbA₁c) measurements in patients with chronic kidney disease (CKD) by three ion-exchange chromatography methods.
Design And Methods: We included three ion-exchange chromatography methods (Bio-Rad Variant II, G7 and HA-8160) and one affinity chromatography method (Primus Ultra2) to test HbA₁c. In vitro carbamylation of haemoglobin was also performed to test interference of carbamylation.
Results: 152 CKD patients were diagnosed. The average HbA₁c and urea levels of nondiabetic and diabetic patients were 5.24% (33.8 mmol/mol) and 7.36% (56.9 mmol/mol) and 16.2 mmol/L and 11.2 mmol/L, respectively. Repeated measures ANOVA showed that the difference of HbA₁c values between four methods is not statistically significant (P=0.421 for non-DM and P=0.336 for DM). With the increase in blood urea concentration from stage 3 to stage 5, there was no corresponding increase in HbA1c values for both groups. In vitro carbamylation results showed that carbamylated Hb peaks could be clearly identified by the three ion-exchange methods.
Conclusion: HbA1c measurement by these methods may not be impacted by carbamylated Hb. The results should be interpreted with caution in high carbamylated Hb patients.
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