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Objective: Metabolic abnormalities contribute to increases in the mortality rate of patients on hemodialysis. Here, we estimate the importance and influence of metabolic syndrome and malnutrition on mortality rate., Design: This was a follow-up study., Methods: We examined the demographic characteristics of time on dialysis, body mass index, indications for hospitalization, treatment outcomes, and biochemical parameters over a 4-year period., Results: Whereas 31.7% of patients had metabolic syndrome, 26.7% showed evidence of malnutrition. More than two thirds of the malnourished patients died. Many patients (46%) with malnutrition were hospitalized because of problems with vascular access, whereas hospitalization of half of the examined patients with metabolic syndrome was attributable to cardiovascular disorders. Differences between groups in the parameters of anemia, total proteins, albumin, and low-density lipoprotein cholesterol also occurred, with the lowest values in malnourished patients. Glycemia, total cholesterol, and fibrinogen were significantly higher in patients with metabolic syndrome, whereas those with malnutrition had a markedly higher concentration of C-reactive protein. The mean survival was 24 months with metabolic syndrome and 17.5 months with malnutrition, which was significantly shorter., Conclusions: More than half of the examined patients had metabolic abnormalities. Patients with malnutrition had a lower rate of survival compared with those who had metabolic syndrome. Two thirds of our malnourished patients died, and the total rate of mortality in the examined sample was 38%.

Aim: The aim of this study was to determine the survival of patients treated by peritoneal dialysis (PD) and hemodialysis (HD) and to detect any association with the type of metabolic changes. Methods: The outcome of clinical treatment of 407 dialysis patients was analyzed over a 4-year period. This included the demographic characteristics, the duration of dialysis, smoking, residual renal function, existence of metabolic syndrome and malnutrition, waist girth, body mass index (BMI), comorbidity, and routine biochemical parameters. Results: The overall mortality of the treated patients during the 4-year period was 53%, 37% for HD patients and 65% for PD patients. Metabolic syndrome was the dominant metabolic disorder affecting more than half of the HD patients, as well as being a predictive mortality parameter (β = 0.560; p = 0.045). The PD-treated patients had an equal prevalence of metabolic syndrome and malnutrition, whereas statistically significant predictors of mortality outcome were BMI (β = 0.088; p = 0.002) and waist girth (β = 0.023; p = 0.031). The median survival value was significantly higher for HD patients [108 months; 95% confidence interval (CI) 65–151]. Residual renal function in PD patients was significantly related to mortality ( p = 0.045). Conclusion: Metabolic syndrome is a predictive parameter of mortality for HD patients, whereas for PD patients it is the waist girth and BMI. Preserved residual renal function in patients on PD is an important factor in reducing mortality. [ABSTRACT FROM AUTHOR]