Prevalence of Chronic Kidney Disease in Patients with Metabolic Syndrome in Ukraine

The article presents data on the frequency of detection of chronic kidney disease (CKD) in patients with metabolic syndrome in Ukraine. CKD screening was conducted in 316 patients who came for a consultative examination to an endocrinologist. The objective: to determine the prevalence of chronic kidney disease among patients with metabolic syndrome. Materials and methods. The average age of the patients was 61.75 ± 0.83 years, body mass index (BMI) – 34.64 ± 0.28 kg/m2, among them women – 56.3%, and men – 43.7%. Among the examined patients, 37.3% of persons had a history of type 2 diabetes, 84.8% – arterial hypertension, 100.0% – obesity and 86.3% – dyslipidemia. According to the BMI, the rate of patients with class 1 obesity was 25.3%, class 2 – 25.3 %, class 3 – 10.1 %. The presence of CKD was determined using estimated glomerular filtration rate (GFR) (based on creatinine level according to the CKD-EPI Creatinine formula), as well as determination of albuminuria – the ratio of albumin to creatinine. Results. Among the examined patients, CKD stage I was diagnosed in 15.8%, stage II – 60.4%, stage III – 16.1%, stage IV – 6.6% and stage V – 0.9%. The urine albumin-creatinine ratio (uACR) A1 was detected in 42.7% of cases, A2 – in 56.6% and A3 – in 0.6% of the examined persons. When calculating the risk of developing the end-stage CKD in our study, 42.1% of the patients had a low risk, 40.5% – a moderate risk, 8.9% – a high risk, and 8.5% of patients had a very high risk. A negative effect was found between HbA1c on GFR (regression coefficient B = –0.018; 95% confidence interval (CI) [from –0.031 to –0.005], p = 0.008) and also a positive correlation with uACR (regression coefficient B = 12.27; 95% CI [4.67–19.88]), p = 0.002. According to the regression analysis, a positive relationship was noted between uACR and BMI (regression coefficient B = 1.32; 95% CI [0.35–2.28], p = 0.08). Therefore, weight gain affects an increase in uACR but not GFR (regression coefficient B = 0.002; 95% CI [–0.034–0.029], p = 0.89). Conclusions. Among patients with metabolic syndrome, CKD stages III–V are diagnosed in 23.6%. High and very high risk of end-stage CKD was found in 17.4% of people. Such patients need to conduct regular monitoring of GFR and albuminuria at least 3–4 times a year and conservative treatment under the supervision of a nephrologist. A negative factor affecting GFR and uACR is glycated hemoglobin and BMI. No relationship was found with other indicators.