METABOLIC SYNDROME IN PATIENTS WITH THE LONG TIME HEMODIALYSIS TREATMENT

Gamidov İ. M., Jalalov M. R.

CLINICAL AND EXPERIMENTAL MEDICINE

Scentific article

Summarizing clinical and laboratory indicators of lipid and carbohydrate metabolism, Metabolic Syndrome (MS) possesses a significant role in the course and prognosis of both diabetes and cardiovascular disorders, as well as Chronic Kidney Disease (CKD), which served as a basis to investigate MS in patients treated with hemodialysis on a long-term basis. 150 cases with the age range of 25-60 were assessed, of which 96 consisted of males and 54 females. Hemodialysis was performed using FRESENIUS 4008S equipment three times weekly with each session lasting 4 hours. Control group (Group I) included 95 patients who received conservative treatment for renal failure (RF), stages I and II. Cause of RF was glomerulonephritis in 26 cases, diabetes in 28, chronic pyelonephritis in 13, urolithiasis in 14, renal poly-cystic disease in 6, and hypertension in 8 patients. 55 patients (Group II) had been receiving hemodialysis for over 10 years, among which 16 chronic pyelonephritis, 13 kidney stone disease, 5 interstitial nephritis, 12 diabetes, and 3 hypertensive disease cases were identified. In comparison with chronic glomerulonephritis and kidney poly-cystic disease cases, MS had a higher likelihood of occurrence in cases of diabetes, long-term hypertensive disease, and urolithiasis. Duration of hypertensive disease was positively associated (Р=0.63) with MS with extremely high triglyceride levels. Persistent hypertension, diabetes, and cardiovascular disorders were positively associated with decreased dimensions of abdomen, when compared to other complications. In long-term hemodialysis, glucose tolerance tended to decline with age. Lower glomerular filtration rate resulted in decreased amount of subdermal abdominal fat tissue. Based on our findings, MS poses a high risk for elderly patients with CKD. Analysis of cumulative survival demonstrated that age group 20-45 had higher survival rate (93%), whereas age groups 46-59 and 60-75 had moderate (75%) and lower (49%) survival rates, respectively. Analysis of mortality rates showed that age at the beginning of hemodialysis is a statistically significant survival predictor. Higher age of the patient upon initiation of hemodialysis increased risk of death by 1,5% within first year of treatment. Conducted studies have shown that a positive trend is observed in manifestation of Metabolic Syndrome with decreased glomerular filtration rate and subsequently, increased renal failure. Existing MS changes deteriorate with age and addition of various complications. Primary diseases play an important role in survival of patients who are administered hemodialysis. In patients who receive long-term dialysis therapy, levels of triglycerides and low-density cholesterol frequently increased, whereas concentration of glucose was prone to decline.

metabolic syndrome, hemodialysis, chronic renal disease

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