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fibrinogen&#44; C-reactive protein&#44; glucose&#44; calcium&#44; phosphorus&#44; intact parathyroid hormone&#44; uric acid and lipid profile&#41;&#46; Compared with the non-MS patients&#44; those with MS had higher atrial fibrillation &#40;16&#37; vs&#46; 8&#37;&#41;&#44; left ventricular mass index &#40;75&#37; vs&#46; 68&#37;&#41; and diastolic dysfunction parameters &#40;42&#37; vs&#46; 30&#37;&#41; estimated using eco-Doppler&#46; The presence of cardiovascular events was higher in patients with MS &#40;53&#37; vs&#46; 44&#37;&#41;&#44; mainly due to ischaemic heart disease &#40;21&#37; vs&#46; 6&#37;&#41; and peripheral heart disease &#40;26&#37; vs&#46; 15&#37;&#41;&#46; Likewise&#44; patients with MS had more days of hospitalisation &#40;44&#46;5 vs&#46; 23&#46;2 days mean&#47;patient&#41;&#46; We additionally analysed the treatment prescribed to our patients intended for controlling cardiovascular risk factors &#40;MS vs&#46; non-MS&#41;&#58; antiplatelet therapy &#40;65&#37; vs&#46; 46&#37;&#41;&#44; statins &#40;50&#37; vs&#46; 31&#37;&#41; allopurinol &#40;13&#37; vs&#46; 3&#37;&#41;&#44; angiotensin-converting-enzyme inhibitors or angiotensin receptor blockers &#40;43&#37; vs&#46; 32&#37;&#41;&#44; beta-blockers &#40;46&#37; vs&#46; 34&#37;&#41;&#44; calcium channel blockers &#40;30&#37; vs&#46; 22&#37;&#41;&#46;</p><p class="elsevierStylePara">Similarly to this study and those previously published in the literature<span class="elsevierStyleSup">3-5</span>&#44; we observed a high prevalence of MS in patients in our study&#44; although the differences observed may have been linked to their demographic characteristics &#40;older and with greater comorbidity&#41; and the high presence of associated risk factors&#46; Likewise&#44; our patients with MS had greater comorbidity and cardiovascular events&#44; resulting in longer hospitalisation&#46; In our study&#44; we did not observe differences in biochemical or inflammation data&#59; however&#44; the worse functional and structural cardiac impairment of patients with MS could in part explain the greater presence of cardiovascular events and comorbidity in them&#46;</p><p class="elsevierStylePara">The aim of our comment is to re-affirm the high prevalence of MS in patients on HD&#44; as well as expressing our opinion in relation to performing dysthanasia&#44; with the aim of reducing their high cardiovascular morbidity and mortality&#46; Moreover&#44; we agree with the authors about the need for studies with a higher number of patients and a longer follow-up period in order to establish definitive conclusions about morbidity and mortality of MS in HD patients&#46;</p><p class="elsevierStylePara">&#160;</p><p class="elsevierStylePara"><span class="elsevierStyleBold">Conflicts of interest</span></p><p class="elsevierStylePara">&#160;</p><p class="elsevierStylePara">The authors declare that they have no conflicts of interest related to the contents of this article&#46;</p>"
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Comment on 'Metabolic syndrome is associated with cardiovascular events in haemodialysis'
Comentario a «El síndrome metabólico se asocia con eventos cardiovasculares en hemodiálisis»
Vicent Esteve-Simoa, Mònica Pou-Potaua, Miquel Fulquet-Nicolasa, Manel Ramírez-de Arellanoa
a Servicio de Nefrología, Consorci Sanitari de Terrassa, Barcelona,
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    "textoCompleto" => "<p class="elsevierStylePara"><span class="elsevierStyleBold">To the Editor&#44;</span></p><p class="elsevierStylePara">We read the article by P&#233;rez de Jos&#233; et al&#46; recently published in Nefrolog&#237;a<span class="elsevierStyleSup">1 </span>with great interest&#46; In this study&#44; the authors referred to both the prevalence of metabolic syndrome &#40;MS&#41; and its association with the greater presence of cardiovascular events in the haemodialysis &#40;HD&#41; population&#46;</p><p class="elsevierStylePara">We had previously reported a study on the prevalence&#44; clinical characteristics and biochemical parameters of MS according to the criteria of the National Cholesterol Education Program &#40;NCEP&#41;-Adult Treatment Panel &#40;ATP III&#41; in our HD unit<span class="elsevierStyleSup">2</span>&#46; We carried out a descriptive analysis of 55 patients&#44; comparing those diagnosed with MS &#40;23 patients&#41; with the rest of the patients in our HD unit&#46; Patients with MS had a mean age of 70&#46;9&#177;12&#46;5 years and had been on HD for 35&#46;8&#177;38&#46;5 months&#46; The mean Charlson index was 10&#46;5&#177;2&#46;2 and the main aetiology of kidney disease was diabetes mellitus &#40;39&#37;&#41;&#46; Its main traditional risk factors were high blood pressure &#40;90&#37;&#41; and diabetes mellitus &#40;76&#37;&#41;&#46; In the diagnosis of MS&#44; 80&#37; had impaired glucose&#44; 85&#37; had impaired HDL-cholesterol&#44; 65&#37; had hypertriglyceridaemia&#44; 56&#37; had abdominal obesity and 53&#37; had high blood pressure&#46; The prevalence of MS was 42&#37; &#40;47&#37; males&#41;&#46; We did not find differences between groups in relation to sex or primary kidney disease&#44; although patients with MS had a larger abdominal girth &#40;105&#46;7&#177;14&#46;1 vs&#46; 96&#46;1&#177;11&#46;8&#41; and a shorter time on HD &#40;35&#46;8&#177;38&#46;5 vs&#46; 82&#46;6&#177;105&#46;8 months&#41;&#46; Likewise&#44; we did not observe differences in biochemical parameters &#40;haemoglobin&#44; fibrinogen&#44; C-reactive protein&#44; glucose&#44; calcium&#44; phosphorus&#44; intact parathyroid hormone&#44; uric acid and lipid profile&#41;&#46; Compared with the non-MS patients&#44; those with MS had higher atrial fibrillation &#40;16&#37; vs&#46; 8&#37;&#41;&#44; left ventricular mass index &#40;75&#37; vs&#46; 68&#37;&#41; and diastolic dysfunction parameters &#40;42&#37; vs&#46; 30&#37;&#41; estimated using eco-Doppler&#46; The presence of cardiovascular events was higher in patients with MS &#40;53&#37; vs&#46; 44&#37;&#41;&#44; mainly due to ischaemic heart disease &#40;21&#37; vs&#46; 6&#37;&#41; and peripheral heart disease &#40;26&#37; vs&#46; 15&#37;&#41;&#46; Likewise&#44; patients with MS had more days of hospitalisation &#40;44&#46;5 vs&#46; 23&#46;2 days mean&#47;patient&#41;&#46; We additionally analysed the treatment prescribed to our patients intended for controlling cardiovascular risk factors &#40;MS vs&#46; non-MS&#41;&#58; antiplatelet therapy &#40;65&#37; vs&#46; 46&#37;&#41;&#44; statins &#40;50&#37; vs&#46; 31&#37;&#41; allopurinol &#40;13&#37; vs&#46; 3&#37;&#41;&#44; angiotensin-converting-enzyme inhibitors or angiotensin receptor blockers &#40;43&#37; vs&#46; 32&#37;&#41;&#44; beta-blockers &#40;46&#37; vs&#46; 34&#37;&#41;&#44; calcium channel blockers &#40;30&#37; vs&#46; 22&#37;&#41;&#46;</p><p class="elsevierStylePara">Similarly to this study and those previously published in the literature<span class="elsevierStyleSup">3-5</span>&#44; we observed a high prevalence of MS in patients in our study&#44; although the differences observed may have been linked to their demographic characteristics &#40;older and with greater comorbidity&#41; and the high presence of associated risk factors&#46; Likewise&#44; our patients with MS had greater comorbidity and cardiovascular events&#44; resulting in longer hospitalisation&#46; In our study&#44; we did not observe differences in biochemical or inflammation data&#59; however&#44; the worse functional and structural cardiac impairment of patients with MS could in part explain the greater presence of cardiovascular events and comorbidity in them&#46;</p><p class="elsevierStylePara">The aim of our comment is to re-affirm the high prevalence of MS in patients on HD&#44; as well as expressing our opinion in relation to performing dysthanasia&#44; with the aim of reducing their high cardiovascular morbidity and mortality&#46; Moreover&#44; we agree with the authors about the need for studies with a higher number of patients and a longer follow-up period in order to establish definitive conclusions about morbidity and mortality of MS in HD patients&#46;</p><p class="elsevierStylePara">&#160;</p><p class="elsevierStylePara"><span class="elsevierStyleBold">Conflicts of interest</span></p><p class="elsevierStylePara">&#160;</p><p class="elsevierStylePara">The authors declare that they have no conflicts of interest related to the contents of this article&#46;</p>"
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Article information
ISSN: 20132514
Original language: English
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