Studies were undertaken to determine levels of hemoglobin A1 in renal and heart transplant recipients. Hemoglobin A1 was measured by separation from Hb A using an affinity-column chromatography system. Significantly elevated levels of Hb A1 were found in all renal transplant patients; diabetic transplant recipients had the highest levels. There was no correlation between serum creatinine and Hb A1 levels in these transplant recipients. The Hb A1 level did correlate with the prior level of glycemia in these patients. Our findings raised the specter of the consequences of disturbed carbohydrate metabolism in these patients as not being different than that observed with other forms of end-stage renal disease management. Finally, in both diabetic and nondiabetic renal transplant recipients, measurement of Hb A1 can serve as a useful adjunct to assess prior glycemia when such information is not available to the clinician.

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