Metabolic syndrome and other cardiovascular risk factors associated with the progression of IgA nephropathy

Tibor Kovács, Tibor Vas, Csaba P. Kovesdy, István Késõi, Balázs Sági, I. Wittmann, J. Nagy

Research output: Contribution to journalArticle

5 Citations (Scopus)

Abstract

BackgroundThe metabolic syndrome is associated with modest but independent and additive risk of new onset chronic kidney disease (CKD) in several studies. The purpose of our study was to determine whether metabolic syndrome and other cardiovascular risk factors (hyperuricaemia and smoking) are associated with the progression of IgA nephropathy (IgAN).MethodsTwo hundred and twenty three IgAN patients (107 with and 116 without metabolic syndrome) were examined. The primary renal end point was doubling of serum creatinine; secondary end points were reaching eGFR of ≤ 60 ml/min/1,73m2 or eGFR of ≤30 ml/min/1.73 m2, and end-stage renal disease, ESRD (the composite of serum creatinine ≥500 μmol/l, initiation of dialysis treatment or transplantation). The association of metabolic syndrome with renal end points was examined using the Kaplan-Meier method and Cox models.ResultsMetabolic syndrome established at the diagnosis or during follow-up of IgAN patients was significantly associated with the primary renal end point (unadjusted hazard ratio of doubling of serum creatinine, 95% confidence interval: 1.96 (1.17-1.33, p = 0.011). The association remained significant after adjustment for confounders: 1.70 (1.02-3.83, p = 0.040). Results were similar for secondary end points except ESRD which was not associated with the presence of metabolic syndrome. Hyperuricaemia and smoking were independent risk factors of progression. Survival curves stratified on metabolic syndrome status showed significant differences for the end points (p = 0.017-0.001) except for ESRD.ConclusionsEarly diagnosis and treatment of metabolic syndrome, hyperuricaemia and smoking may be an additional cost-effective strategy for preventing the progression of IgAN.

Original languageEnglish
Pages (from-to)395-401
Number of pages7
JournalClinical Kidney Journal
Volume6
Issue number4
DOIs
Publication statusPublished - 2013

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Metabolic Syndrome X
Immunoglobulin A
Chronic Kidney Failure
Creatinine
Smoking
Kidney
Serum
Chronic Renal Insufficiency
Proportional Hazards Models
Dialysis
Transplantation
Confidence Intervals
Costs and Cost Analysis
Survival
Therapeutics

Keywords

  • cardiovascular risk factors
  • chronic kidney disease progression
  • end-stage renal disease
  • IgA nephropathy
  • metabolic syndrome

ASJC Scopus subject areas

  • Nephrology
  • Transplantation

Cite this

Metabolic syndrome and other cardiovascular risk factors associated with the progression of IgA nephropathy. / Kovács, Tibor; Vas, Tibor; Kovesdy, Csaba P.; Késõi, István; Sági, Balázs; Wittmann, I.; Nagy, J.

In: Clinical Kidney Journal, Vol. 6, No. 4, 2013, p. 395-401.

Research output: Contribution to journalArticle

Kovács, Tibor ; Vas, Tibor ; Kovesdy, Csaba P. ; Késõi, István ; Sági, Balázs ; Wittmann, I. ; Nagy, J. / Metabolic syndrome and other cardiovascular risk factors associated with the progression of IgA nephropathy. In: Clinical Kidney Journal. 2013 ; Vol. 6, No. 4. pp. 395-401.
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AU - Vas, Tibor

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AU - Sági, Balázs

AU - Wittmann, I.

AU - Nagy, J.

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N2 - BackgroundThe metabolic syndrome is associated with modest but independent and additive risk of new onset chronic kidney disease (CKD) in several studies. The purpose of our study was to determine whether metabolic syndrome and other cardiovascular risk factors (hyperuricaemia and smoking) are associated with the progression of IgA nephropathy (IgAN).MethodsTwo hundred and twenty three IgAN patients (107 with and 116 without metabolic syndrome) were examined. The primary renal end point was doubling of serum creatinine; secondary end points were reaching eGFR of ≤ 60 ml/min/1,73m2 or eGFR of ≤30 ml/min/1.73 m2, and end-stage renal disease, ESRD (the composite of serum creatinine ≥500 μmol/l, initiation of dialysis treatment or transplantation). The association of metabolic syndrome with renal end points was examined using the Kaplan-Meier method and Cox models.ResultsMetabolic syndrome established at the diagnosis or during follow-up of IgAN patients was significantly associated with the primary renal end point (unadjusted hazard ratio of doubling of serum creatinine, 95% confidence interval: 1.96 (1.17-1.33, p = 0.011). The association remained significant after adjustment for confounders: 1.70 (1.02-3.83, p = 0.040). Results were similar for secondary end points except ESRD which was not associated with the presence of metabolic syndrome. Hyperuricaemia and smoking were independent risk factors of progression. Survival curves stratified on metabolic syndrome status showed significant differences for the end points (p = 0.017-0.001) except for ESRD.ConclusionsEarly diagnosis and treatment of metabolic syndrome, hyperuricaemia and smoking may be an additional cost-effective strategy for preventing the progression of IgAN.

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