{"doi":"10.1016/j.ekir.2020.04.020","title":"Glycemic Control and Infections Among US Hemodialysis Patients With Diabetes Mellitus","abstract":"IntroductionPatients with diabetes mellitus (DM) on hemodialysis (HD) may be particularly vulnerable to infections.MethodsWe used merged data from the United States Renal Data System and electronic health records data from a large US dialysis provider to retrospectively examine the association between glycemic control and infections in these patients. Adult patients with DM aged ≥18 years who initiated in-center maintenance HD treatment from 2006 to 2011 and survived >90 days were included. Quarterly mean time-averaged hemoglobin A1c (HbA1c) values were categorized into <5.5%, 5.5 to <6.5%, 6.5 to <7.5%, 7.5 to <8.5%, and ≥8.5%. We used Medicare claims to ascertain infection-related outcomes and the ESRD Death Notification to identify death from infectious cause. We used Cox proportional hazards models to estimate multivariable-adjusted hazard ratios and 95% confidence intervals (CIs) for the associations between time-averaged HbA1c categories and infectious events.ResultsIn a cohort of 33,753 eligible patients, those with higher HbA1c levels had higher rates of diabetic foot infections and skin and soft tissue infections, with patients with HbA1c ≥8.5% having 23% (95% CI, 5%, 45%) and 22% (95% CI, 5%, 42%) higher rates, respectively, compared with HbA1c 5.5 to <6.5%. Patients in the lower HbA1c categories had higher rates of infection-related and all-cause mortality (P-for-trend <0.001).ConclusionThis study highlights the need for greater attention to foot evaluation and skin and soft tissue infections among patients on HD with less than optimal diabetes control.","journal":"Kidney International Reports","year":2020,"id":82665,"datarank":0.0,"base_score":0.0,"endowment":0.0,"self_citation_contribution":0.0,"citation_network_contribution":0.0,"self_endowment_contribution":0.0,"citer_contribution":0.0,"corpus_percentile":null,"corpus_rank":null,"citation_count":12,"citer_count":0,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":0.935,"is_data_producer":false,"deposit_databanks":null,"is_oa":true,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":"2020-01-01","fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":278642,"name":"Yuanchao Zheng","orcid":"0000-0001-7571-3054","position":1,"is_corresponding":false},{"id":426205,"name":"Sai Liu","orcid":"0000-0002-1611-2643","position":2,"is_corresponding":false},{"id":234902,"name":"Maria E. Montez‐Rath","orcid":"0000-0001-5154-2182","position":3,"is_corresponding":false},{"id":426206,"name":"Richard J. Hamill","orcid":"0000-0002-0491-9626","position":4,"is_corresponding":false},{"id":269663,"name":"Julie H. Ishida","orcid":null,"position":5,"is_corresponding":false},{"id":109012,"name":"Wolfgang C. Winkelmayer­","orcid":"0000-0002-5272-425X","position":6,"is_corresponding":false},{"id":329366,"name":"Jinnie J. Rhee","orcid":"0000-0001-8990-0379","position":0,"is_corresponding":true}],"reference_count":38,"raw_metadata":null,"created_at":"2026-07-18T21:53:48.608934Z","pmid":"32647759","pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}