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NDT Plus Advance Access originally published online on June 27, 2008
NDT Plus 2008 1(4):206-214; doi:10.1093/ndtplus/sfn073
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© The Author [2008]. Published by Oxford University Press on behalf of ERA-EDTA. All rights reserved. For Permissions, please e-mail: journals.permissions@oxfordjournals.org

Metabolic syndrome in peritoneal dialysis patients

Philip Kam-Tao Li1, Bonnie Ching-Ha Kwan1, Cheuk Chun Szeto1 and Gary Tin-Choi Ko2

1 Department of Medicine & Therapeutics, Prince of Wales Hospital
2 Hong Kong Institute of Diabetes and Obesity, The Chinese University of Hong Kong, Shatin, Hong Kong SAR, China

Correspondence: Philip Kam-Tao Li, Department of Medicine & Therapeutics, The Chinese University of Hong Kong, Prince of Wales Hospital, Ngan Shing St, Shatin, Hong Kong. Tel: +852-2632-3616; Fax: +852-2637-5396; E-mail: philipli{at}cuhk.edu.hk


  Abstract

Cardiovascular morbidity and mortality are common in peritoneal dialysis patients. Metabolic syndrome (MES) is a medical condition with a clustering of major risk factors for cardiovascular diseases. In this review article, the various diagnostic criteria used in MES are discussed. It is proposed to use a modified National Cholesterol Education Programme Adult Treatment Panel III (NCEP ATP III) criteria for the diagnosis of MES in peritoneal dialysis (PD) patients taking into consideration the scientific evidence and practicality. When three or more of the following criteria are satisfied in PD patients, obesity, high triglyceride, low high-density lipoprotein cholesterol (HDL-C), hypertension or dysglycaemia, they are diagnosed as having MES. Body mass index (BMI) with reference to ethnicity is suggested to replace waist circumference for diagnosing obesity. Epidemiology and outcome of PD patients with MES are highlighted. The adverse sequelae of obesity appear to be primarily due to fat mass rather than non-fat mass, possibly related to the pro-inflammatory effect of adipose tissue. Whilst there are therapies to tackle MES in PD patients, more conclusive data in human studies to see clinically improved outcomes with such strategies are needed.

Key Words: metabolic syndrome • obesity • peritoneal dialysis

Received for publication February 6, 2008. Accepted for publication May 29, 2008.


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