Relationship of metabolic syndrome, hospitalization rate and mortality of hemodialyzed (HD) patients – short communication
Authors:
M. Vostrý 1; D. Rajdl 1; J. Eiselt 2; L. Malánová 3; R. Pikner 4; L. Trefil 1; J. Racek 1
Authors‘ workplace:
Ústav klinické biochemie a hematologie, Univerzita Karlova v Praze - Lékařská fakulta v Plzni a Fakultní nemocnice Plzeň
1; 1. Interní klinika, Univerzita Karlova v Praze - Lékařská fakulta v Plzni a Fakultní nemocnice Plzeň
2; Dialyzační středisko B. Braun Avitum, Plzeň
3; Oddělení klinických laboratoří, Klatovská nemocnice a. s.
4
Published in:
Klin. Biochem. Metab., 23 (44), 2015, No. 2, p. 67-70
Overview
Objective:
To explore the relationship of metabolic syndrome (MS) to the prognosis of hemodialyzed patients – all-cause mortality and hospitalization rate.
Design:
prospective cohort study.
Material and Methods:
117 HD patients (median of age=67 years, BMI=24.9 kg/m2, 62 males) were divided into two groups by the occurrence of MS (60 patients with MS) and prospectively monitored for five years. Exclusion criterion: CRP level>100 mg/l, malignancy. Beside the role of the MS, the impact of several laboratory markers (CRP, albumin, adiponectin, asymmetric dimethylarginine) on mortality has been evaluated.
Results:
66 patients died during the follow-up period (56 %, 34 pts. with MS). No relationship was found between the MS and all-cause mortality (log-rank p=0.6). However, distinction emerged in the analysis of hospitalizations. Patients with MS were hospitalized more frequently and for a longer time period (1.24 vs. 0.91 events per person-year (py); 17.66 vs. 14.05 days per py; both p<0.05). These patients experienced almost twofold higher risk of hospitalization from a cardiovascular cause (adjusted Cox model, HR=2.25, p<0.01). Among the laboratory parameters, only albumin proved as significant predictor of mortality (adjusted Cox model, HR=0.94, p<0.05).
Conclusion:
We observed an insignificant MS impact on all-cause mortality. However, the MS concept may be useful in predicting the risk of complications in hemodialysis patients.
Keywords:
metabolic syndrome, kidney failure – chronic, hemodialysis, mortality, hospitalization.
Sources
1. Perez de Jose, A., Verdalles-Guzman, U. et al. Metabolic syndrome is associated with cardiovascular events in haemodialysis. Nefrologia, 2014, 34, 1, p. 69-75.
2. Stenvinkel, P. Chronic kidney disease: a public health priority and harbinger of premature cardiovascular disease. J. Intern. Med., 2010, 268, 5, p. 456-467.
3. Abbott, K. C., Glanton, C. W. et al. Body mass index, dialysis modality, and survival: analysis of the United States Renal Data System Dialysis Morbidity and Morta-lity Wave II Study. Kidney Int., 2004, 65, 2, p. 597-605.
4. Executive Summary of The Third Report of The National Cholesterol Education Program (NCEP) Expert Panel on Detection, Evaluation, And Treatment of High Blood Cholesterol In Adults (Adult Treatment Panel III). JAMA, 2001, 285, 19, p. 2486-2497.
5. Wu, C. C., Liou, H. H. et al. Abdominal obesity is the most significant metabolic syndrome component predictive of cardiovascular events in chronic hemodialysis patients. Nephrol. Dial. Transplant., 2011, 26, 11, p. 3689-3695.
6. Yang, S. Y., Chiang, C. K. et al. Metabolic syndrome predicts hospitalization in hemodialysis patients: a prospective Asian cohort study. Blood Purif., 2007, 25, 3, p. 252-259.
Labels
Clinical biochemistry Nuclear medicine Nutritive therapistArticle was published in
Clinical Biochemistry and Metabolism
2015 Issue 2
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