Associations of Cardiovascular and All-Cause Mortality with Metabolic Syndrome in Hemodialysis Patients: A Prospective Single-Center Study

Abstract

Background and objectives: Metabolic syndrome (MetS) is a cluster of risk factors, such as abdominal obesity, insulin resistance, dyslipidemia and hypertension, that together increase the risk of cardiovascular disease. Chronic hemodialysis (HD) patients have multiple comorbidities and many metabolic disorders, causing the frequent occurrence of metabolic syndrome. The goal of this study was to assess the prevalence of MetS in HD patients, and its association with all-cause and cardiovascular (CV) mortality. Patients and methods: A total of 138 HD patients were included in this prospective study. We analyzed demographic, anthropometric and biochemical data. Outcome measures were all-cause and CV mortality during the three-year follow-up. Results: MetS was diagnosed in 57.24% of enrolled patients. During the 36 months of follow-up, 33 patients died. MetS patients showed a significantly higher mortality rate than non-MetS (30.4% versus 16.36%, p < 0.001). The association of different MetS components with cardiovascular mortality reached significance when a minimum of three components were present (1.81 (95% confidence interval CI = 1.21–2.33)), with a grouped increase in effect size for subjects with four or five MetS components. Subjects with MetS exhibited nearly twice as high risk for all-cause (hazard ratio HR = 1.99 (95%CI) = 1.42–2.97) and 2.5 times for CV (HR = 2.51 (95%CI) = 1.25–3.83) mortality compared with those without MetS, after adjustment for age, gender, and cardiovascular disease. Conclusions: The study demonstrates that MetS is widespread in HD patients. In future, the focus must be on an active screening approach, and treatment of cardiometabolic risk factors, aiming to reduce mortality.

Interleukin‐6 levels can be used to estimate cardiovascular and all‐cause mortality risk in dialysis patients: A meta‐analysis and a systematic review

“…18,19 In the present meta-analysis, our pooled data showed that IL-6 could forecast all-cause mortality risk in dialysis patients, which could be explained as follows: (1) increased IL-6 indicates an upregulation of inflammatory status in dialysis patients, which could be attributed to infection (including catheter-related infection, peritonitis, bloodstream infection, and so on), metabolic syndrome, and severe pneumonia; these factors could lead to mortality in dialysis patients. [50][51][52][53][54] (2) IL-6 is related to cardiovascular mortality, as shown in a previous analysis, which is also a strong contributor to all-cause mortality. Therefore, higher IL-6 levels were associated with elevated all-cause mortality in dialysis patients in our pooled analysis.…”

Assessment of Relationship Between Serum Vitamin D Levels and Metabolic Syndrome Components in Hemodialysis Patients

“…Also supporting studies made in [9,10,21,24,26], dry weight, BMI, waist circumference, serum triglycerides were significantly higher and HDL-C levels were lower in patients with metabolic syndrome than other groups. As in this study, BMI is also high in patients with metabolic syndrome (p < 0.05), is an independent predictor of metabolic syndrome in hemodialysis patients without diabetes and dyslipidemia [9,15,22,24,27]. These discrepancies in the results of different studies could be attributed to the different populations and healthcare settings between these studies and the current study.…”

Prevalence of carbohydrate metabolism disorders in patients with end-stage renal disease on hemodialysis therapy

“…отметили, что основными причинами, приводящими к снижению чувствительности к инсулину у пациентов с ХБП, являются: анемия, воспаление, оксидативный стресс, дефицит витамина D, метаболический ацидоз, уремическая интоксикация, нездоровый образ жизни [11]. У гемодиализных больных наличие ИР значительно увеличивает частоту возникновений сердечно-сосудистых событий [14,15]. M. Guthoff и соавт.…”