Association of Relatives of Hemodialysis Patients with Metabolic Syndrome, Albuminuria and Framingham Risk Score

Abstract

Background and AimMetabolic syndrome (MetS), albuminuria, and the Framingham Risk Score (FRS) are significant predictors for cardiovascular disease (CVD). However, the relationship and clinical significance of these CVD predictors in individuals with a family history of end-stage renal disease (ESRD) are unclear. We investigated the association of relatives of hemodialysis (HD) patients with MetS, albuminuria, and the FRS.MethodsOne hundred and sixty-six relatives of HD patients and 374 age- and sex- matched community controls were enrolled. MetS was defined using the Adult Treatment Panel III for Asians. Albuminuria was defined as urine albumin-to-creatinine ratio ≥30 mg/g. CVD risk was evaluated by the FRS.ResultsA significantly higher prevalence of MetS (19.9% vs. 12.5%, P = 0.026), albuminuria (12.7% vs. 5.1%, P = 0.002) and high FRS risk ≥10% of 10-year risk (15.7% vs. 8.5%, P = 0.013) was found in relatives of HD patients compared to their counterpart controls. In multivariate analysis, being relatives of HD patients (vs. controls) was an independent determinant for MetS (odds ratio [OR], 1.785; 95% confidence interval [CI], 1.045 to 3.050), albuminuria (OR, 2.891; 95% CI, 1.431 to 5.841), and high FRS risk (OR, 1.863; 95% CI, 1.015 to 3.418). Higher low-density lipoprotein cholesterol (OR, 1.034; 95% CI, 1.017 to 1.052) and betel nut chewing (OR, 13.994; 95% CI, 3.384 to 57.871) were independent determinants for having a high FRS risk in relatives of HD patients.ConclusionsBeing relatives of HD patients was independently associated with MetS, albuminuria and high FRS risk, suggesting family members of ESRD patients may have higher CVD risks through the interactions of renal risk factors. Proactive surveillance of these CVD predictors and preventive strategies should be targeted to this high-risk population.

Relatives in silent kidney disease screening (RISKS) study: A Chinese cohort study

“…Interestingly, a family history of CKD also increased one’s risk of acute renal failure significantly (standardized incidence ratio (SIR) = 1.19) . Furthermore, a recent study suggested that being relatives of haemodialysis patients was independently associated with metabolic syndrome and high cardiovascular risk (defined as ≥10% 10‐year risk of Framingham Risk Score), after adjustment for albuminuria . Therefore, it is reasonable to implement strategies in this high‐risk population for the early detection of kidney disease (both acute and chronic) and cardiovascular diseases.…”

“…12 Furthermore, a recent study suggested that being relatives of haemodialysis patients was independently associated with metabolic syndrome and high cardiovascular risk (defined as ≥10% 10-year risk of Framingham Risk Score), after adjustment for albuminuria. 13 Therefore, it is reasonable to implement strategies in this high-risk population for the early detection of kidney disease (both acute and chronic) and cardiovascular diseases. Urine dipstick, a simple and convenient test, had been used to screen asymptomatic individuals in largescale cohorts; single measurement of proteinuria by dipstick was shown to independently predict risk of ESRD and cardiovascular mortality.…”

Prevalence and determinants of the metabolic syndrome among subjects with advanced nondiabetes-related chronic kidney disease in Gran Canaria, Spain

“…23 In this regard, an increased prevalence of the metabolic syndrome has been observed among relatives of patients with endstage renal disease (ESRD). 24 In our study, apart from age, family history of diabetes was the variable most strongly associated with the metabolic syndrome. All these data are in alignment with the idea that subjects with metabolic syndrome, diabetes and advanced CKD share a common genetic background.…”

Protein C and protein S deficiencies may be related to survival among hemodialysis patients

“…HD patients were reported to have a family history of CKD or ESRD and a higher risk for developing these conditions [24], and the leading cause of death among HD patients is cardiovascular disease [6]. Additionally, the presence of a residual thrombus after the first episode of DVT is an independent risk factor for recurrence [25].…”