Effect of metabolic syndrome on clinical outcomes of non‐diabetic peritoneal dialysis patients in India. Issue 10 (19th September 2013)

• Record Type: Journal Article
• Authors: Prasad, Narayan; Sinha, Archana; Gupta, Amit; Sharma, Raj K; Kaul, Anupama; Bhadauria, Dharmender; Ranagswamy, Dharshan
• Is Part Of: Nephrology. Volume 18:Issue 10(2013)
• Page Start: 657
• Page End: 664
• Publication Date: 2013-09-19
• Subjects: Nephrology -- Periodicals; Kidneys -- Diseases -- Periodicals; Nephrologists -- Periodicals; 616.61; 616.61
• DOI: 10.1111/nep.12124
• Languages: English
• ISSNs: 1320-5358

Abstract

<abstract abstract-type="main"> <title>Abstract</title> <sec id="nep12124-sec-0001" sec-type="section"> <title>Aim</title> <p>Metabolic syndrome (MS) is associated with higher mortality and morbidity in the general population. However, the effect of MS and its individual components on clinical outcomes in non‐diabetic peritoneal dialysis (PD) patients has not been widely studied in India. Our aim was to study the prevalence of MS in non‐diabetic PD patients who were on PD for at least 3 months and to analyze the influence of MS and its individual components on clinical outcomes of these patients on subsequent follow up.</p> </sec> <sec id="nep12124-sec-0002" sec-type="section"> <title>Methods</title> <p>We prospectively included 163 non‐diabetic PD patients (mean age 45.1 ± 16.2 years, 104 male). MS was defined using the modified National Cholesterol Education Programme (ATP III) criteria. Outcomes of patients with and without MS were compared.</p> </sec> <sec id="nep12124-sec-0003" sec-type="section"> <title>Results</title> <p>Of the 163 non‐diabetic PD patients, 84 (51.5%) patients had MS. The mean follow up duration was 24.0 ± 14.0 patient months. Patients with MS had significantly greater body mass index (<italic>P</italic> = 0.007), Systolic BP (<italic>P</italic> = 0.001), diastolic BP (<italic>P</italic> = 0.001), Triglycerides (<italic>P</italic> = 0.002), total cholesterol (<italic>P</italic> = 0.001) level; and significantly lower high density lipoprotein (<italic>P</italic> = 0.013) values. Mean survival (patient‐months) of patients with MS (30.7 (95%CI 27.1–34.3)) was significantly inferior to that of patients without MS (55.6 (95% CI 50.8–60.4), <italic>P</italic> = 0.001). Mean technique survival of patients with MS was also significantly lower (38.9 (95% CI 35.9–41.9)) compared to that of patients without MS (61.5 (95% CI 58.3–64.7), <italic>P</italic> = 0.039). On univariate Cox regression analysis diastolic BP (<italic>P</italic> = 0.003), Systolic BP (<italic>P</italic> = 0.026), hypertension (HTN) (<italic>P</italic> = 0.001) and MS (<italic>P</italic> = 0.001) were found to be independent predictors of mortality. However on multivariate Cox hazard regression analysis, only MS (HR 5.39 (95% CI 2.06–14.14), <italic>P</italic> = 0.001) was found to be the significant predictors of mortality in these patients. Among the factors other than components of MS, the presence of comorbidities (<italic>P</italic> = 0.029), serum albumin (<italic>P</italic> = 0.042), non‐HDL cholesterol (<italic>P</italic> = 0.003), total cholesterol/HDL (<italic>P</italic> = 0.001) and MS (<italic>P</italic> = 0.001) were important factors predicting mortality on univariate Cox regression, while only MS (<italic>P</italic> = 0.001) and serum albumin (<italic>P</italic> = 0.013) were the independent factors predicting mortality on multivariate analysis.</p> </sec> <sec id="nep12124-sec-0004" sec-type="section"> <title>Conclusion</title> <p>Prevalence of MS in non‐diabetic PD patient is high and predicts long term patient and technique survival.</p> </sec> </abstract>