Assess the effect of impaired glucose tolerance on cardiovascular events, renal outcomes and mortality. Neil Boudville has no relevant financial affiliations that would cause a conflict of interest according to the conflict of interest statement set down by CARI. Nicole Isbel has no relevant financial affiliations that would cause a conflict of interest according to the conflict of interest statement set down by CARI. “
“Aim:  Due to altered red blood cell survival and erythropoietin therapy glycated haemoglobin (HbA1c) INCB024360 may not accurately reflect long-term glycaemic control in patients with diabetes and chronic kidney

disease (CKD). Glycated albumin (GA) and fructosamine are alternative markers of glycaemia. The aim of this study was to investigate the accuracy of HbA1c, GA and fructosamine as indicators of glycaemic control using continuous glucose monitoring. Methods:  HbA1c, GA and fructosamine concentrations were measured in 25 subjects with diabetic nephropathy (CKD stages 4 and 5 (estimated glomerular filtration rate <30 mL/min per 1.73 m2)) matched with 25 subjects with diabetes and no evidence of nephropathy. Simultaneous real-time glucose

concentrations were monitored by continuous glucose monitoring over 48 h. Results:  GA correlated significantly to mean glucose concentrations in patients with and without CKD (r = 0.54 vs 0.49, P < 0.05). A similar relationship was observed with fructosamine relative to glucose. A poor correlation BYL719 between HbA1c and glucose was observed with CKD (r = 0.38, P = ns) but was significant in the non-CKD group (r = 0.66, P < 0.001). The GA/HbA1c ratio was significantly higher in diabetic patients with CKD compared with controls (2.5 ± 0.4 vs 2.2 ± 0.4, P < 0.05). HbA1c values were significantly lower in CKD patients, relative to non-CKD patients at comparable mean glucose concentrations. Conclusion:  HbA1c significantly Branched chain aminotransferase underestimates glycaemic control in patients with diabetes and CKD stages 4 and 5. In severe CKD, GA more accurately reflects glycaemic

control compared with fructosamine and HbA1c and should be the preferred marker of glycaemic control. “
“Date written: December 2008 Final submission: June 2009 No recommendations possible based on Level I or II evidence (Suggestions are based primarily on Level III and IV evidence) Gadolinium-enhanced magnetic resonance angiography (MRA) is highly sensitive in detecting atherosclerotic renal artery stenosis (RAS) and is significantly more accurate in excluding the disease. Gadolinium-based imaging should be avoided in patients with glomerular filtration <30 mL/min per 1.73 m2 because of the risk of nephrogenic systemic fibrosis. Screening tests of diagnosis of RAS will depend on the availability and institutional expertise with a particular modality.