1,5-anhydroglucitol as a marker for the differential diagnosis of acute and chronic renal failure

Serum creatinine and 1,5-anhydroglucitol (1,5-AG) were measured in 21 non-dialysis acute renal failure (ARF) and 32 chronic renal failure (CRF) patients. Fasting blood glucose was under 100 mg/dl and no patient had a history of diabetes mellitus. Serum 1,5-AG decreased with increase in serum creatinine in CRF, but not in ARF patients. A significant negative correlation was found between serum 1,5-AG and creatinine in CRF patients (r = -0.592, p < 0.001). Serum 1,5-AG in patients with serum creatinine of 4 mg/dl or more was less than the lowest limit of the normal range in 14 of 15 CRF patients, but only 2 of 12 ARF patients. In these 27 patients, serum 1,5-AG was significantly higher in ARF than CRF (19.0 +/- 5.9 vs. 7.2 +/- 4.1 micrograms/ml, p < 0.01). From these results, it would follow that serum 1,5-AG should serve effectively as a marker for the differential diagnosis of nondiabetic ARF and CRF.