914 METABOLIC DISORDERS PREDICT NEW ONSET OF CHRONIC KIDNEY DISEASE IN THE JAPANESE GENERAL POPULATION

Abstract

Purpose: Metabolic syndrome (MetS) and chronic kidney disease (CKD) are important cardiovascular risks. We investigated the predictive values of MetS and its components for new onset of CKD. Methods: Consecutive 10048 subjects with normal estimated glomerular filtration rate (eGFR; ≥60 mL/min/1.73m2) who visited our hospital for a physical check-up (male = 65.1%, 53.7 ± 11.2 year-old) were enrolled and followed up for 1644 days (median) with the endpoint being the development of CKD (eGFR < 60 mL/min/1.73m2). Subjects with obesity (body mass index ≥25 kg/m2) were defined as having MetS if they have two or more of the following disorders; (1) triglycerides ≥150 mg/dl and/or high density-lipoprotein cholesterol < 40 mg/dl and/or use of anti-dyslipidemic medication, (2) systolic blood pressure ≥130mmHg and/or diastolic blood pressure ≥85mmHg and/or use of antihypertensive medication, and (3) fasting plasma glucose ≥110 mg/dl and/or use of anti-diabetic medication. Results: During the follow-up, CKD developed in 902 subjects (20.4 per 1000 person-year). The incidence was more frequent in subjects with (28.2 per 1000 person-year) than without MetS (19.7 per 1000 person-year, p < 0.01). The incidence of CKD was increased with increasing the number of metabolic disorders in individuals at baseline. In multivariate Cox hazard analysis, Mets was an independent predictor of the new onset of CKD after adjustment for known risk factors. Similar results were obtained in subanalysis using subjects without any medications (n = 8309). Conclusions: MetS and its components are important predictors for new onset of CKD. Prediction of the onset of CKD may lead to effective prevention of CKD and relating cardiovascular disease.