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- Title
Effect of metabolic syndrome on clinical outcomes of non-diabetic peritoneal dialysis patients in India.
- Authors
Prasad, Narayan; Sinha, Archana; Gupta, Amit; Sharma, Raj K; Kaul, Anupama; Bhadauria, Dharmender; Ranagswamy, Dharshan
- Abstract
Aim 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. Methods 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. Results 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 ( P = 0.007), Systolic BP ( P = 0.001), diastolic BP ( P = 0.001), Triglycerides ( P = 0.002), total cholesterol ( P = 0.001) level; and significantly lower high density lipoprotein ( P = 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), P = 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), P = 0.039). On univariate Cox regression analysis diastolic BP ( P = 0.003), Systolic BP ( P = 0.026), hypertension ( HTN) ( P = 0.001) and MS ( P = 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), P = 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 ( P = 0.029), serum albumin ( P = 0.042), non- HDL cholesterol ( P = 0.003), total cholesterol/ HDL ( P = 0.001) and MS ( P = 0.001) were important factors predicting mortality on univariate Cox regression, while only MS ( P = 0.001) and serum albumin ( P = 0.013) were the independent factors predicting mortality on multivariate analysis. Conclusion Prevalence of MS in non-diabetic PD patient is high and predicts long term patient and technique survival.
- Subjects
INDIA; METABOLIC syndrome; HEMODIALYSIS patients; DISEASE prevalence; PEOPLE with diabetes
- Publication
Nephrology, 2013, Vol 18, Issue 10, p657
- ISSN
1320-5358
- Publication type
Article
- DOI
10.1111/nep.12124