Metabolic syndrome and cardiovascular disease risk in end-stage renal disease patients

Background and Aims : Cardiovascular disease (CVD) is one of the most common causes of morbidity and mortality in chronic kidney disease (CKD), especially in end-stage renal disease (ESRD). Metabolic syndrome (MS) is known to predispose to a higher CVD risk. It is likely that the co-existence of MS and CKD may enhance CVD risk factors. We aim to evaluate in ESRD patients on hemodialysis (HD), the impact of MS on conventional and non-conventional biomarkers of CVD risk.Methods: We studied 308 ESRD patients on HD (2015-2019); 47 had MS according to World Health Organization classification. We evaluated lipid profile, HDL subfractions, adiponectin, leptin, tissue plasminogen activator (tPA), plasminogen activator inhibitor (PAI)-1, fetuin-A, asymmetric dimethylarginine (ADMA), elastase, and leukocyte and neutrophil counts.Results: ESRD patients with MS (ESRD/MS), as compared to ESRD without MS, presented lower total cholesterol (TC) and low-density lipoprotein cholesterol (LDLc), and higher TC/HDLc ratio; lower(%) of large HDL and higher(%) of small and intermedium HDL subfractions. ESRD/MS patients also presented higher leukocyte and neutrophil counts, higher elastase, leptin, tPA, PAI-1 and ADMA levels, and lower adiponectin and fetuin-A concentrations.Conclusions: Despite the lower cholesterol and LDLc in MS/ESRD patients, they showed more atherogenic changes, namely, lower large HDL%, the more atheroprotective subfraction, and higher small HDL%, the less protective subfraction; imbalance of anti- and pro-inflammatory adipokines; and, risk changes in biomarkers of inflammation, endothelial (dys)function and arterial calcification. Our data show a higher risk profile for CVD in ESRD/MS patients. Acknowledgment: UIDP/04378/2020 and UIDB/04378/2020; LA/P/0140/2020; PTDC/MEC-CAR/31322/2017; FCT/MCTES (PTDC/MEC-CAR/31322/2017) and FEDER/COMPETE 2020 (POCI-01-0145-FEDER-031322). Background and Aims : Cardiovascular disease (CVD) is one of the most common causes of morbidity and mortality in chronic kidney disease (CKD), especially in end-stage renal disease (ESRD). Metabolic syndrome (MS) is known to predispose to a higher CVD risk. It is likely that the co-existence of MS and CKD may enhance CVD risk factors. We aim to evaluate in ESRD patients on hemodialysis (HD), the impact of MS on conventional and non-conventional biomarkers of CVD risk. Methods: We studied 308 ESRD patients on HD (2015-2019); 47 had MS according to World Health Organization classification. We evaluated lipid profile, HDL subfractions, adiponectin, leptin, tissue plasminogen activator (tPA), plasminogen activator inhibitor (PAI)-1, fetuin-A, asymmetric dimethylarginine (ADMA), elastase, and leukocyte and neutrophil counts. Results: ESRD patients with MS (ESRD/MS), as compared to ESRD without MS, presented lower total cholesterol (TC) and low-density lipoprotein cholesterol (LDLc), and higher TC/HDLc ratio; lower(%) of large HDL and higher(%) of small and intermedium HDL subfractions. ESRD/MS patients also presented higher leukocyte and neutrophil counts, higher elastase, leptin, tPA, PAI-1 and ADMA levels, and lower adiponectin and fetuin-A concentrations. Conclusions: Despite the lower cholesterol and LDLc in MS/ESRD patients, they showed more atherogenic changes, namely, lower large HDL%, the more atheroprotective subfraction, and higher small HDL%, the less protective subfraction; imbalance of anti- and pro-inflammatory adipokines; and, risk changes in biomarkers of inflammation, endothelial (dys)function and arterial calcification. Our data show a higher risk profile for CVD in ESRD/MS patients. Acknowledgment: UIDP/04378/2020 and UIDB/04378/2020; LA/P/0140/2020; PTDC/MEC-CAR/31322/2017; FCT/MCTES (PTDC/MEC-CAR/31322/2017) and FEDER/COMPETE 2020 (POCI-01-0145-FEDER-031322).