Metabolic Syndrome in Peritoneal Dialysis Patients: Choice of Diagnostic Criteria and Prognostic Implications

⋄ Background Serum ghrelin levels are elevated in uremic patients. However, no data are available on the relationship between metabolic syndrome and serum ghrelin levels in peritoneal dialysis (PD) patients. ⋄ Methods Metabolic syndrome and its components were defined using diagnostic criteria recommended by the International Diabetes Federation. Fasting serum samples were taken from 30 PD patients. Serum ghrelin levels were measured by using a commercial enzyme-linked immunosorbent assay kit. ⋄ Results Of the 30 PD patients, 53.3% (16/30) had metabolic syndrome. Fasting serum ghrelin corrected inversely with metabolic syndrome among these PDs patients ( p = 0.002). By odds ratio (OR) analysis of metabolic syndrome and metabolic syndrome diagnostic criteria, the predictors for metabolic syndrome are fasting glucose [OR: 39.00; 95% confidence interval (CI): 3.80 to 399.85; p < 0.001], triglycerides (OR: 37.50; 95% CI: 3.64 to 386.51; p < 0.001), and waist circumference (OR: 4.20; 95% CI: 1.95 to 9.03; p < 0.001). Univariate linear regression analysis showed that body weight ( r = –0.461, p = 0.010), waist circumference ( r = –0.390, p = 0.033), and body mass index ( r = –0.438, p = 0.016) were negatively correlated with serum ghrelin, and serum high density lipoprotein [HDL ( r = 0.626, p < 0.001)] was positively correlated with serum ghrelin. Multivariate forward stepwise linear regression analysis of the significant variables showed that HDL ( R2 change = 0.392; p < 0.001) was the independent predictor of serum ghrelin in PD patients and explained 39.2% of the variance. ⋄ Conclusions These results indicate an inverse association between circulating fasting ghrelin and metabolic syndrome in PD patients. Serum HDL was associated with serum ghrelin among PD patients.

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Metabolic syndrome and abdominal fat are associated with inflammation, but not with clinical outcomes, in peritoneal dialysis patients

Cardiovascular Diabetology ◽

10.1186/1475-2840-12-86 ◽

2013 ◽

Vol 12 (1) ◽

pp. 86 ◽

Cited By ~ 7

Author(s):

Jenq-Wen Huang ◽

Chung-Yi Yang ◽

Hon-Yen Wu ◽

Kao-Lang Liu ◽

Chi-Ting Su ◽

...

Keyword(s):

Metabolic Syndrome ◽

Peritoneal Dialysis ◽

Clinical Outcomes ◽

Abdominal Fat ◽

Dialysis Patients

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Assessment of Nutritional Status and Metabolic Syndrome in Peritoneal Dialysis Patients: A Pilot Study

Gazi Medical Journal ◽

10.12996/gmj.2017.56 ◽

2017 ◽

Vol 28 (3) ◽

Keyword(s):

Metabolic Syndrome ◽

Peritoneal Dialysis ◽

Pilot Study ◽

Nutritional Status ◽

Dialysis Patients

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Clinical characterization and prognostic implications of metabolic syndrome in patients undergoing peritoneal dialysis at a Chinese center

Journal of International Medical Research ◽

10.1177/0300060519875335 ◽

2019 ◽

Vol 47 (11) ◽

pp. 5573-5583

Author(s):

Rui-Ning Zhang ◽

Hui-Fang Hao ◽

Wei Zhang ◽

Qing Li ◽

Li-Jie Ren ◽

...

Keyword(s):

Cardiovascular Disease ◽

Metabolic Syndrome ◽

Peritoneal Dialysis ◽

Hospital Admissions ◽

Density Lipoprotein ◽

Serum Calcium Concentration ◽

Neutrophil Percentage ◽

Prognostic Implications ◽

Correlation Trend ◽

A Prospective Study

Objective Metabolic syndrome (MS) is a common clinical condition associated with cardiovascular disease in patients undergoing peritoneal dialysis (PD); however, its prognostic implication among patients receiving PD remains controversial. Methods In a prospective study from January 2013 and June 2016, we enrolled 190 patients undergoing PD and followed them for 46.4 ± 30.7 months. We assessed the associations of clinical characteristics and measurements with diabetes mellitus (DM) status, MS, and prognostic outcomes among the included patients. Results We found that DM was associated with shortened duration of dialysis and poor survival. The prevalence of MS was 58.9% among all patients. We found significant differences in age, body weight, body mass index, triglycerides, high-density lipoprotein cholesterol, fasting plasma glucose, leukocytes, platelets, neutrophil percentage, and pre-albumin between patients with and without MS. We found a negative correlation trend between serum intact parathyroid hormone and MS among our patients. The arteriosclerosis index was significantly elevated in the MS group compared with the non-MS group. Serum calcium concentration and frequency of hospital admissions were significantly associated with mortality and technique failure. Conclusions MS was positively associated with cardiovascular disease. DM, and hypocalcemia. Frequent hospital admissions can predict poor prognosis in patients undergoing PD.

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Fasting Serum Adiponectin Level Inversely Correlates with Metabolic Syndrome in Peritoneal Dialysis Patients

Blood Purification ◽

10.1159/000314647 ◽

2010 ◽

Vol 30 (1) ◽

pp. 1-7 ◽

Cited By ~ 9

Author(s):

Chih-Hsien Wang ◽

Ji-Hung Wang ◽

Chung-Jen Lee ◽

Te-Chao Fang ◽

Hung-Hsiang Liou ◽

...

Keyword(s):

Metabolic Syndrome ◽

Peritoneal Dialysis ◽

Adiponectin Level ◽

Serum Adiponectin ◽

Dialysis Patients ◽

Fasting Serum ◽

Serum Adiponectin Level

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Metabolic syndrome in peritoneal dialysis patients

Clinical Kidney Journal ◽

10.1093/ndtplus/sfn073 ◽

2008 ◽

Vol 1 (4) ◽

pp. 206-214 ◽

Cited By ~ 3

Author(s):

P. K.-T. Li ◽

B. C.-H. Kwan ◽

C. C. Szeto ◽

G. T.-C. Ko

Keyword(s):

Metabolic Syndrome ◽

Peritoneal Dialysis ◽

Dialysis Patients

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Correlation of Metabolic Syndrome with Residual Renal Function, Solute Transport Rate and Peritoneal Solute Clearance in Chronic Peritoneal Dialysis Patients

Blood Purification ◽

10.1159/000113506 ◽

2008 ◽

Vol 26 (2) ◽

pp. 138-144 ◽

Cited By ~ 13

Author(s):

Hung-Yuan Chen ◽

Tze-Wah Kao ◽

Jenq-Wen Huang ◽

Tzong-Shinn Chu ◽

Kwan-Dun Wu

Keyword(s):

Metabolic Syndrome ◽

Renal Function ◽

Peritoneal Dialysis ◽

Solute Transport ◽

Residual Renal Function ◽

Transport Rate ◽

Chronic Peritoneal Dialysis ◽

Dialysis Patients ◽

Solute Clearance

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Relationship between Metabolic Syndrome and Inflammation in Peritoneal Dialysis Patients

European Journal of Inflammation ◽

10.1177/1721727x1201000205 ◽

2012 ◽

Vol 10 (2) ◽

pp. 203-207

Author(s):

A. Borazan ◽

E. Ucar ◽

M. Gursu ◽

I. Emir ◽

Y. Ozturk

Keyword(s):

Metabolic Syndrome ◽

Peritoneal Dialysis ◽

Dialysis Patients

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Treatment of Metabolic Syndrome in Peritoneal Dialysis Patients

Peritoneal Dialysis International ◽

10.1177/089686080902902s29 ◽

2009 ◽

Vol 29 (2_suppl) ◽

pp. 149-152 ◽

Cited By ~ 10

Author(s):

Philip Kam-Tao Li ◽

Bonnie Ching-Ha Kwan ◽

Gary Tin-Choi Ko ◽

Kai-Ming Chow ◽

Chi Bon Leung ◽

...

Keyword(s):

Metabolic Syndrome ◽

Peritoneal Dialysis ◽

National Cholesterol Education Program ◽

Large Scale ◽

Lifestyle Modification ◽

Obese Patients ◽

Adult Treatment Panel ◽

Dialysis Patients ◽

Therapeutic Trials ◽

Increased Risk

Metabolic syndrome (MetS) occurs in about 50% of peritoneal dialysis (PD) patients. It encompasses a cluster of major risk factors for cardiovascular diseases. A modified National Cholesterol Education Program Third Adult Treatment Panel guideline for the diagnosis of MetS in PD patients has been proposed. Preliminary data suggest that PD patients with MetS in our cohort have an increased risk of cardiovascular mortality. The proinflammatory effects of adipose tissue are one of the reasons for poor outcome in obese PD patients. Lifestyle modification, including appropriate dietary restriction and exercise, especially reduction of fat mass in obese patients, has been one of the major areas proposed for managing patients with MetS. Individual therapeutic trials are treating hyperglycemia, hypertension, and dyslipidemia in dialysis patients. Evidence in PD patients that interventions targeting MetS can improve outcomes is still lacking. Large-scale studies with data on the clinical outcome for MetS intervention in PD patients are needed.

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