Metabolic syndrome predicts mortality in non-diabetic patients on continuous ambulatory peritoneal dialysis.
BACKGROUND
Metabolic syndrome is associated with higher morbidity and mortality in the general population, but the corresponding effects in patients on dialysis have not been clearly defined. In this study, we prospectively investigated the effect of metabolic syndrome and its individual components on outcome in non-diabetic peritoneal dialysis (PD) patients. Method. The study subjects included 106 stable non-diabetic PD patients who had been on PD for >3 months. We measured baseline characteristics, blood pressure, fasting blood glucose, lipid profiles and high-sensitivity CRP (hsCRP), and defined metabolic syndrome using the modified National Cholesterol Education Program (Adult Treatment Panel III) criteria. Mortality, technical failure and hospitalization were evaluated during the follow-up period.


RESULTS
Metabolic syndrome was present in 50 patients (47.2%), and these showed higher baseline hsCRP levels (0.67; 95% CI: 0.50-0.94 versus 1.78 mg/dl; 95% CI: 1.21-2.57; P < 0.001). Patients with metabolic syndrome experienced significantly lower 5-year survival rates than patients without (90% versus 67%, P = 0.02), although these groups did not differ in peritonitis rates, technical failure or hospitalization. A Cox proportional hazards analysis identified the following as predictors of mortality: metabolic syndrome (RR: 3.39; 95% CI: 1.16-9.94; P = 0.02), baseline albumin (RR: 0.06; 95% CI: 0.01-0.30; P = 0.001) and baseline hsCRP levels (RR: 1.14; 95% CI: 1.07-1.22; P < 0.001).


CONCLUSIONS
Metabolic syndrome is prevalent and is a risk factor influencing long-term survival in non-diabetic PD patients.
Park
Jung Tak
JT
Department of Internal Medicine, College of Medicine, Brain Korea 21 for Medical Science, Yonsei University, Korea.
Chang
Tae Ik
TI
Kim
Dong Ki
DK
Lee
Jung Eun
JE
Choi
Hoon Young
HY
Kim
Hyun Wook
HW
Chang
Jae Hyun
JH
Park
Sun Young
SY
Kim
Eunyoung
E
Yoo
Tae-Hyun
TH
Han
Dae-Suk
DS
Kang
Shin-Wook
SW
D005260:Female; D006801:Humans; D007676:Kidney Failure, Chronic / Q000150:complications / Q000401:mortality* / Q000628:therapy*; D008297:Male; D024821:Metabolic Syndrome / Q000150:complications*; D008875:Middle Aged; D010531:Peritoneal Dialysis, Continuous Ambulatory; D011379:Prognosis; D011446:Prospective Studies