The influence of metabolic syndrome on chronic kidney disease patients′ clinical outcomes

Abstract

Objective To investigate whether metabolic syndrome (MS) independently influences the renal outcomes of chronic kidney disease (CKD) 1-4 stage patients. Methods Since July 2006 to September 2008, a total of 766 clinically stable CKD patients in the hospital were enrolled in this prospective study and followed up until December 31th, 2016. The CKD patients were divided into MS group and non-MS group according to the Chinese Diabetes Society (CDS) criterion of MS. The renal outcomes that needs to initiate renal replacement therapy were observed and recorded during the follow-up. Kaplan-Meier analysis was used to evaluate the influence of MS on CKD patients′ renal outcomes. Cox regression analysis was used to assess the independent risk factors of renal outcome of CKD patients. Results Among 766 patients with CKD 1-4 stage, 97 patients initiated renal replacement therapy, and the prevalence of MS was 31.5%(241/766) in CKD patients. In the CKD 1-4 stage patients, the occurring rate of initiating renal replacement therapy was significantly higher in MS group than that of non-MS group (χ2=56.367, P<0.001). Cox regression analysis showed that 24-hour urine protein ≥1.0 g, MS and initial serum phosphate ≥1.3 mmol/L were the independent risk factors of initiating renal replacement therapy in CKD 1-4 stages. Conclusions More than 1/3 CKD patients are accompanied with MS. It has been demonstrated that MS, as well as 24-hour urine protein ≥1.0 g and initial serum phosphate ≥1.3 mmol/L, are the independent influencing factors of the renal outcomes in CKD 1-4 stage patients. Key words: Metabolic syndrome X; Kidney diseases; Kidney failure, chronic; Risk factors