Impact of Metabolic Syndrome and Malnutrition on Mortality in Chronic Hemodialysis Patients
published online 25 May 2009.
Objective
Metabolic abnormalities contribute to increases in the mortality rate of patients on hemodialysis. Here, we estimate the importance and influence of metabolic syndrome and malnutrition on mortality rate.
Design
This was a follow-up study.
Methods
We examined the demographic characteristics of time on dialysis, body mass index, indications for hospitalization, treatment outcomes, and biochemical parameters over a 4-year period.
Results
Whereas 31.7% of patients had metabolic syndrome, 26.7% showed evidence of malnutrition. More than two thirds of the malnourished patients died. Many patients (46%) with malnutrition were hospitalized because of problems with vascular access, whereas hospitalization of half of the examined patients with metabolic syndrome was attributable to cardiovascular disorders. Differences between groups in the parameters of anemia, total proteins, albumin, and low-density lipoprotein cholesterol also occurred, with the lowest values in malnourished patients. Glycemia, total cholesterol, and fibrinogen were significantly higher in patients with metabolic syndrome, whereas those with malnutrition had a markedly higher concentration of C-reactive protein. The mean survival was 24 months with metabolic syndrome and 17.5 months with malnutrition, which was significantly shorter.
Conclusions
More than half of the examined patients had metabolic abnormalities. Patients with malnutrition had a lower rate of survival compared with those who had metabolic syndrome. Two thirds of our malnourished patients died, and the total rate of mortality in the examined sample was 38%.
∗Kosovska Mitrovica Internal Clinic, University of Pristina/K. Mitrovica, Faculty of Medicine Pristina/K. Mitrovica, Anri Dinana bb, Kosovska, Mitrovica, Serbia
†Institute of Medical Statistics and Informatics, Faculty of Medicine Pristina/Kosovska Mitrovica, University of Pristina/K. Mitrovica, Kosovska, Mitrovica, Serbia
ABSTRACT