Abstract
We investigated whether changes in MetS status over two years modify the 10-year risk of CKD and proteinuria. A prospective cohort study was conducted in 7,251 subjects without CKD at baseline. We categorized subjects according to MetS status over two years: non-MetS (no MetS at either visit), intermittent MetS (positive for MetS at one assessment), and persistent MetS (positive for MetS at two assessments). The hazard ratio (HR) of new-onset CKD over 10-year was calculated using Cox models. During the 10-year follow-up period, 923 (12.7%) developed CKD. Compared to the non-MetS group, the fully adjusted HR for new-onset CKD was the highest in the persistent MetS group (HR, 1.53; 95% CI, 1.23–1.90), followed by the intermittent MetS group (HR, 1.29; 95% CI, 1.04–1.59) (P for trend <0.001). The HR for developing proteinuria was 1.79 (95% CI, 1.15–2.79) in the persistent MetS group and 0.70 (95% CI, 0.42–1.19) in the intermittent MetS group when the non-MetS group was considered as the reference group. Temporal changes in MetS status over two years influenced the 10-year risk of incident CKD and proteinuria. Our findings suggest that monitoring and strictly controlling MetS are important in preventing renal function decline.
Highlights
Recent prospective studies and meta- analyses have shown that the presence of metabolic syndrome (MetS) at baseline is a risk factor for developing CKD8
In this large prospective cohort study of Korean adults, we observed the relationship of MetS status changes over 2 years with renal function decline during a 10-year follow-up period
MetS has been known for decades to be a risk factor for CKD, these findings suggest that an individual’s early patterns of change in MetS status may provide additional information about his or her risk of development of CKD
Summary
Recent prospective studies and meta- analyses have shown that the presence of metabolic syndrome (MetS) at baseline is a risk factor for developing CKD8. Ohnishi et al reported that long-term presence of MetS status, rather than MetS status at a given moment, is more closely associated with a higher risk of diabetes[10]. From these findings, we hypothesized that the change patterns of MetS status over time may vary among individuals; longitudinal change of MetS may have independent impact on the renal dysfunction. The relationship of longitudinal changes in MetS with renal function decline has not been investigated in a large scale epidemiologic study. The relationship of MetS status duration with incident proteinuria, a clinical indicator of kidney function decline before CKD onset[12,13], has not been determined until now. The aim of this study was to determine the independent association of the change of MetS status, based on two assessments of MetS status over 2 years, with the 10-year risk of CKD in a large cohort study of an apparently healthy population
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