El Ati Zohra, Machfar Hanene, Boussafa Hamza, Ati Nidhal, Omrane Sioud Olfa Ben, Zantour Baha, Bouzidi Hassen, Elati Mohamed
Department of Hemodialysis, Tahar Sfar Hospital, Mahdia; Faculty of Medicine, Monastir University, Monastir, Tunisia.
Department of Biochemistry, Tahar Sfar Hospital, Mahdia, Tunisia.
Saudi J Kidney Dis Transpl. 2020 Jan-Feb;31(1):129-135. doi: 10.4103/1319-2442.279932.
Metabolic disorder contributes to the increase in the mortality rate of patients on hemodialysis (HD). The aim of this study was to estimate the prevalence of metabolic syndrome (MS) and malnutrition in patients on maintenance HD and to evaluate their influence on cardiovascular and all-cause mortality during the follow-up. We carried out a prospective cross- sectional study in which we enrolled 100 patients from a single center who had been followed up for three years. Collected data included demographic characteristics, detailed medical history, clinical variables, MS variables, nutritional status, and laboratory findings. The outcomes were the occurrence of a cardiovascular event and cardiovascular or all-cause mortality during the follow-up period. The Statistical Package for the Social Sciences software was used for statistical analysis. Whereas 50% of patients had MS, 23% showed evidence of malnutrition. Patients with MS were older and had more preexisting cardiovascular diseases (CVDs). All patients were followed for 36 months. During this time, 19 patients with MS and 14 patients without MS died (38% vs. 28%; P = 0.19), most frequently of CVD. Mean survival time was 71.52 ± 42.1 months for MS group versus 92.06 ± 65 months for non-MS group, but the difference was not significant. MS was related with a higher cardiovascular mortality, while malnutrition was significantly associated with all-cause mortality. Our data showed that MS was not related to cardiovascular or all-cause mortality in HD patients and did not influence survival. The independent risk factors for all-cause mortality were older age, preexisting CVD, and malnutrition.
代谢紊乱导致血液透析（HD）患者死亡率上升。本研究旨在评估维持性血液透析患者代谢综合征（MS）和营养不良的患病率，并评估它们在随访期间对心血管和全因死亡率的影响。我们进行了一项前瞻性横断面研究，纳入了来自单一中心的100例患者，对其进行了三年的随访。收集的数据包括人口统计学特征、详细病史、临床变量、MS变量、营养状况和实验室检查结果。观察指标为随访期间心血管事件的发生情况以及心血管或全因死亡率。使用社会科学统计软件包进行统计分析。50%的患者患有MS，23%有营养不良迹象。患有MS的患者年龄更大，既往心血管疾病（CVD）更多。所有患者均随访36个月。在此期间，19例患有MS的患者和14例未患MS的患者死亡（38%对28%；P = 0.19），最常见的死因是CVD。MS组的平均生存时间为71.52±42.1个月，非MS组为92.06±65个月，但差异不显著。MS与较高的心血管死亡率相关，而营养不良与全因死亡率显著相关。我们的数据表明，MS与HD患者的心血管或全因死亡率无关，也不影响生存。全因死亡率的独立危险因素是年龄较大、既往有CVD和营养不良。
