One-Year Renal Function in Patients with Chronic Renal Failure and Metabolic Syndrome

Document Type : Original Article (s)

Authors

1 Professor, Kidney Diseases Research Center AND Department of Internal Medicine, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran

2 Student of Medicine, Student Research Committee, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran

3 Associate Professor, Kidney Diseases Research Center AND Department of Internal Medicine, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran

4 Professor, Department of Biostatistics and Epidemiology, School of Health, Isfahan University and Medical Sciences, Isfahan, Iran

5 Kidney Diseases Research Center, Isfahan University of Medical Sciences, Isfahan, Iran

Abstract

Background: Recently, chronic renal failure (CRF) has increased worldwide. CRF is a major risk factor to end-stage renal diseases. The incidence of metabolic syndrome (MS) and its cardiovascular complications is common in patients CRF, too. In this study, we compared renal function in patients with CRF and with or without metabolic syndrome.Methods: This study was conducted in 2017 among 100 patient with CRF with glomerular filtration rate (GFR) of 15-60 ml/min/1.73m2, 50 patients with and 50 without metabolic syndrome. Metabolic syndrome criteria, as well as serum creatinine were measured in all the patients each 3 months till 1 year.Findings: 42 patients were women and 58 were men. The mean GFR was not significantly different among the patients with or without metabolic syndrome (P = 0.322) in 1-year follow up. In 3-month follow ups, only there was a significant association between systolic blood pressure and GFR with metabolic syndrome (P = 0.028, P = 0.030, P = 0.020, and P = 0.15 in 1st, 2nd, 3rd, and 4th 3-month follow up). In 1-year follow up, there was no significant association between other metabolic syndrome criteria and GFR in patients with metabolic syndrome [P = 0.214, P = 0.061, P = 0.409, P = 0.315, and P = 0.284 for abdominal obesity, diastolic blood pressure, triglyceride, high-density lipoprotein (HDL), and fasting blood sugar (FBS)].Conclusion: Metabolic syndrome does not any effect on renal function in patients with CRF. We recommend further studies with longer follow-up period.

Keywords


  1. Gilbertson DT, Liu J, Xue JL, Louis TA, Solid CA, Ebben JP, et al. Projecting the number of patients with end-stage renal disease in the United States to the year 2015. J Am Soc Nephrol 2005; 16(12): 3736-41.
  2. Go AS, Chertow GM, Fan D. Chronic kidney disease and the risks of death, cardiovascular events, and hospitalization. J Vasc Surg 2005; 41(1): 177.
  3. Bargman JM, Skorecki K.Chronic kidney disease. In: Kasper DL, Fauci AS, Hauser SL, Longo DL, Jameson JL, Loscalzo J, editors. Harrison's principles of internal medicine. 19th ed. New York, NY: McGraw-Hill Education; 2015. p. 1811.
  4. Oda E. Metabolic syndrome: its history, mechanisms, and limitations. Acta Diabetol 2012; 49(2): 89-95.
  5. Grundy SM, Brewer HB, Cleeman J, I, Smith SC, Lenfant C. Definition of Metabolic Syndrome. Circulation 2004; 109(3): 433-8.
  6. Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults. Executive Summary of the Third Report of the National Cholesterol Education Program (NCEP) Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel III). JAMA 2001; 285(19): 2486-97.
  7. Athyros VG, Ganotakis ES, Tziomalos K, Papageorgiou AA, Anagnostis P, Griva T, et al. Comparison of four definitions of the metabolic syndrome in a Greek (Mediterranean) population. Curr Med Res Opin 2010; 26(3): 713-9.
  8. Kosulwat V. The nutrition and health transition in Thailand. Public Health Nutr 2002; 5(1A): 183-9.
  9. Mottillo S, Filion KB, Genest J, Joseph L, Pilote L, Poirier P, et al. The metabolic syndrome and cardiovascular risk a systematic review and meta-analysis. J Am Coll Cardiol 2010; 56(14): 1113-32.
  10. Schrier RW, Estacio RO, Esler A, Mehler P. Effects of aggressive blood pressure control in normotensive type 2 diabetic patients on albuminuria, retinopathy and strokes. Kidney Int 2002; 61(3): 1086-97.
  11. Singh AK, Kari JA. Metabolic syndrome and chronic kidney disease. Curr Opin Nephrol Hypertens 2013; 22(2): 198-203.
  12. Chen J, Gu D, Chen CS, Wu X, Hamm LL, Muntner P, et al. Association between the metabolic syndrome and chronic kidney disease in Chinese adults. Nephrol Dial Transplant 2007; 22(4): 1100-6.
  13. Watanabe H, Obata H, Watanabe T, Sasaki S, Nagai K, Aizawa Y. Metabolic syndrome and risk of development of chronic kidney disease: the Niigata preventive medicine study. Diabetes Metab Res Rev 2010; 26(1): 26-32.
  14. Stevens LA, Coresh J, Greene T, Levey AS. Assessing kidney function--measured and estimated glomerular filtration rate. N Engl J Med 2006; 354(23): 2473-83.
  15. Huh JH, Yadav D, Kim JS, Son JW, Choi E, Kim SH, et al. An association of metabolic syndrome and chronic kidney disease from a 10-year prospective cohort study. Metabolism 2017; 67: 54-61.
  16. Lucove J, Vupputuri S, Heiss G, North K, Russell M. Metabolic syndrome and the development of CKD in American Indians: the Strong Heart Study. Am J Kidney Dis 2008; 51(1): 21-8.
  17. Tozawa M, Iseki C, Tokashiki K, Chinen S, Kohagura K, Kinjo K, et al. Metabolic syndrome and risk of developing chronic kidney disease in Japanese adults. Hypertens Res 2007; 30(10): 937-43.
  18. Song H, Wang X, Cai Q, Ding W, Huang S, Zhuo L. Association of metabolic syndrome with decreased glomerular filtration rate among 75,468 Chinese adults: a cross-sectional study. PLoS One 2014; 9(11): e113450.
  19. Mortazavi M, Seirafian S, Emami Naini A, Zamani N, Moien N. The prevalence of metabolic syndrome in patients on hemodialysis and peritoneal dialysis: A comparative study. J Isfahan Med Sch 2012; 29(171): 2722-31. [In Persian].