| Objective:To investigate the prevalence of Metabolic Syndrome in patients undergoing maintenance peritoneal dialysis, and the effect of metabolic syndrome on prognosis of patients survival.Method:A retrospective study was performed with patients undergoing peritoneal dialysis from October 2002 to July 2014 in the first affiliated hospital of Zhejiang University School of medicine, who were followed up regularly and had dialyzed more than 3 months. We analyzed the laboratory results and follow-up data at baseline,3 months,6 months,12 months,24 months,36 months,48 and 60 months after peritoneal dialysis. According to the metabolic syndrome diagnostic criteria, dividing the patients into the metabolic syndrome group and non-metabolic syndrome group, compare the survival prognosis between the two group patients.Result:1. We enrolled 1014 patients undergoing maintenance peritoneal dialysis, at the baseline of dialysis the mean FBG level is 4.80±1.23mmol/L, the prevalence rate of hyperglycemia was 21.01%; The mean BMI was 21.52±5.80 kg/m2, the prevalence rate of obesity was 13.12%; The mean TG was 1.59±1.09mmol/L, the prevalence rate of hypertriglyceridemia was 32.34%; The mean HDL was 1.09±0.34mmol/L, the prevalence rate of low high-density lipoprotein cholesterol was 59.76%; The mean SBP was 147.89±21.75mmHg, the mean DBP was 90.36±14.40mmHg, the prevalence of hypertension was 96.74%; The prevalence of metabolic syndrome was 36.88%; 2. There were 374 patients diagnosed metabolic syndrome, and 640 patients were in non-metabolic syndrome group. At the baseline of dialysis, there were significant difference in metabolic syndrome related factors, such as the morbidity of diabetes mellitus, BMI, FBG, TG, HDL, however there was no difference in blood pressure and mere were no significant difference in age, education, creatinine, eGFR, Calcium, Serum phosphate, hemoglobin, albumin, PTH in the two groups, also there was no significant difference in prognosis factors, such as number of patients received kidney transplant operation, withdraw from peritoneal dialysis and death; 3. With the duration of peritoneal dialysis, the level of mean FBG elevated significantly (p<0.001). The biggest rise was at 3 months after peritoneal dialysis, FBG rose to 1.98±1.10mmol/L. and it was similar with TG level, the level of mean TG elevated significantly after peritoneal dialysis, and 3 months after peritoneal dialysis, TG reached 1.98±1.10mmol/L, which was the biggest rise. The baseline of HDL was 1.98±1.10mmol/L, it rose significantly in the first 3 months to 1.30±0.39mmoI/L, and then it declined and kept stable in one year. The BMI was different. The mean BMI was 21.52±5.80kg/m2 before peritoneal dialysis, it declined significantly in the first 3 months to 21.24±3.28kg/m2 (p<0.05), and then it rose significantly (P<0.01), and reached 21.74±3.17kg/m2 after 2 years of peritoneal dialysis.4. According to the duration of peritoneal dialysis, we made subgroup analysis. In the subgroup of duration of peritoneal dialysis less-than 12 months, there was no significant difference in survival prognosis between MS and non-MS group (p=0.455). And in the subgroup of duration of peritoneal dialysis more-than 12 months, the survival prognosis was significant better in MS group than non-MS group (p=0.04).Conclusion:In the patients undergoing maintenance peritoneal dialysis, the prevalence rate of obesity, hyperglycemia, dyslipidemia are significantly higher, as the duration of peritoneal dialysis, the level of fasting blood glucose and triglycerides, high-density lipoprotein cholesterol were significantly higher.1 year peritoneal after dialysis, the metabolic situation became stable. The prevalence of the metabolic syndrome did not have obvious effect on the short-term prognosis of patients undergoing maintenance peritoneal dialysis, but there might be adversely effect on long-term outcome. |
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