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2013 ; 6
(4
): 395-401
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Metabolic syndrome and other cardiovascular risk factors associated with the
progression of IgA nephropathy
#MMPMID27293567
Kovács T
; Vas T
; Kovesdy CP
; Késői I
; Sági B
; Wittmann I
; Nagy J
Clin Kidney J
2013[Aug]; 6
(4
): 395-401
PMID27293567
show ga
BACKGROUND: The metabolic syndrome is associated with modest but independent and
additive risk of new onset chronic kidney disease (CKD) in several studies. The
purpose of our study was to determine whether metabolic syndrome and other
cardiovascular risk factors (hyperuricaemia and smoking) are associated with the
progression of IgA nephropathy (IgAN). METHODS: Two hundred and twenty three IgAN
patients (107 with and 116 without metabolic syndrome) were examined. The primary
renal end point was doubling of serum creatinine; secondary end points were
reaching eGFR of ? 60 ml/min/1,73m(2) or eGFR of ?30 ml/min/1.73 m(2), and
end-stage renal disease, ESRD (the composite of serum creatinine ?500 ?mol/l,
initiation of dialysis treatment or transplantation). The association of
metabolic syndrome with renal end points was examined using the Kaplan-Meier
method and Cox models. RESULTS: Metabolic syndrome established at the diagnosis
or during follow-up of IgAN patients was significantly associated with the
primary renal end point (unadjusted hazard ratio of doubling of serum creatinine,
95% confidence interval: 1.96 (1.17-1.33, p = 0.011). The association remained
significant after adjustment for confounders: 1.70 (1.02-3.83, p = 0.040).
Results were similar for secondary end points except ESRD which was not
associated with the presence of metabolic syndrome. Hyperuricaemia and smoking
were independent risk factors of progression. Survival curves stratified on
metabolic syndrome status showed significant differences for the end points (p =
0.017-0.001) except for ESRD. CONCLUSIONS: Early diagnosis and treatment of
metabolic syndrome, hyperuricaemia and smoking may be an additional
cost-effective strategy for preventing the progression of IgAN.
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