Correlation of metabolic syndrome with residual renal function, solute transport rate and peritoneal solute clearance in chronic peritoneal dialysis patients

Background: Metabolic syndrome (MetS) and insulin resistance (IR) strongly promote macrovascular complications and endothelial dysfunction. They accelerate the progression of renal dysfunction in chronic kidney disease patients. However, their correlation with residual renal function (RRF) and peritoneal characteristics have never been investigated. Methods: The inter-relationships of IR (homeostatic model assessment, HOMA(IR)), serum adiponectin level, body mass index (BMI), highly sensitive C-reactive protein (hs-CRP), RRF, peritoneal solute clearance (Kt/V-urea) and solute transport rate of 104 chronic peritoneal dialysis (PD) patients were examined. Results: Patients with (n = 57) and without (n = 47) clinically diagnosed MetS had the same degree of RRF, peritoneal Kt/V-urea, and solute transport rate. Higher HOMA(IR) (p = 0.011), BMI (p = 0.01) and hs-CRP (p = 0.032), as well as lower adiponectin (p = 0.019), were associated with lower peritoneal Kt/V-urea. Serum adiponectin was negatively associated with solute transport rate (p = 0.02). In multiple regression analysis, higher HOMA(IR) (p = 0.005), BMI (p = 0.021) and hs-CRP (p < 0.001) correlated with lower peritoneal Kt/V-urea. Conclusions: MetS plays an important role in both macrovascular complications and endothelial dysfunction in chronic PD patients, which correlates with changes in peritoneal solute clearance and solute transport rate but not RRF. Copyright (c) 2008 S. Karger AG, Basel.