High risk of renal outcome of metabolic syndrome independent of diabetes in patients with CKD stage 1–4: The ICKD database

• Published in: Diabetes/metabolism research and reviews Vol. 39; no. 4; pp. e3618 - n/a
• Main Authors: Lin, Hugo Y.‐H., Chang, Li‐Yun, Niu, Sheng‐Wen, Kuo, I‐Ching, Yen, Chia‐Hung, Shen, Feng‐Ching, Chen, Phang‐Lang, Chang, Jer‐Ming, Hung, Chi‐Chih
• Format: Journal Article
• Language: English
• Published: England Wiley Subscription Services, Inc 01.05.2023
• Subjects: Blood pressure; chronic kidney disease; Diabetes; Diabetes mellitus; Diabetes Mellitus - epidemiology; Dialysis; Glomerular Filtration Rate; Humans; Kidney - physiology; Kidney diseases; Kidney Failure, Chronic - complications; Kidney Failure, Chronic - therapy; Metabolic syndrome; Metabolic Syndrome - complications; Metabolic Syndrome - epidemiology; Mortality; Proteinuria; Renal function; Renal Insufficiency, Chronic - complications; Renal Insufficiency, Chronic - epidemiology; renal outcomes; Risk Factors; metabolic syndrome; chronic kidney disease; diabetes mellitus; renal outcomes
• ISSN: 1520-7552; 1520-7560
• DOI: 10.1002/dmrr.3618

Aims To investigate whether metabolic syndrome (MetS) could predict renal outcome in patients with established chronic kidney disease (CKD). Materials and Methods We enroled 2500 patients with CKD stage 1–4 from the Integrated CKD care programme, Kaohsiung for delaying Dialysis (ICKD) prospective observational study. 66.9% and 49.2% patients had MetS and diabetes (DM), respectively. We accessed three clinical outcomes, including all‐cause mortality, RRT, and 50% decline in estimated glomerular filtration rate events. Results The MetS score was positively associated with proteinuria, inflammation, and nutrition markers. In fully adjusted Cox regression, the hazard ratio (HR) (95% confidence interval) of MetS for composite renal outcome (renal replacement therapy, and 50% decline of renal function) in the DM and non‐DM subgroups was 1.56 (1.15–2.12) and 1.31 (1.02–1.70), respectively, while that for all‐cause mortality was 1.00 (0.71–1.40) and 1.27 (0.92–1.74). Blood pressure is the most important component of MetS for renal outcomes. In the 2 by 2 matrix, compared with the non‐DM/non‐MetS group, the DM/MetS group (HR: 1.62 (1.31–2.02)) and the non‐DM/MetS group (HR: 1.33 (1.05–1.69)) had higher risks for composite renal outcome, whereas the DM/MetS group had higher risk for all‐cause mortality (HR: 1.43 (1.09–1.88)). Conclusions MetS could predict renal outcome in patients with CKD stage 1–4 independent of DM.