1. ¹Department of Medicine, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
2. ²Electricity Medical and Health Office, Electricity Generating Authority of Thailand, Nonthaburi, Thailand
3. ³Department of Food Chemistry, Faculty of Pharmacy, Mahidol University, Bangkok, Thailand

Correspondence: C Kitiyakara, Nephrology Division, Department of Medicine, Ramathibodi Hospital, 270 Rama 6 Road, Bangkok 10110, Thailand. E-mail: kitiyakc@yahoo.com

⁴These authors contributed equally to this work

Received 13 July 2006; Revised 7 November 2006; Accepted 20 December 2006; Published online 7 February 2007.

Abstract

US adults with metabolic syndrome, as defined by National Cholesterol Education Program Adult Treatment Panel III (NCEP ATP III) criteria, have been shown to be at increased risk of chronic kidney disease (CKD), but there is limited information in other populations. The relationship between metabolic syndrome and CKD (defined as estimated glomerular filtration rate <60 ml/min/1.73 m²) was examined in a Southeast Asian cohort. This relationship was examined when the subjects (n=3195) were initially recruited in a cross-sectional analysis. The risks of developing new CKD associated with metabolic syndrome were also examined prospectively in a subgroup (n=2067) without CKD at entry after 12 years follow-up. Metabolic syndrome was defined according to both NCEP ATP III and the new International Diabetes Federation (IDF) criteria. The prevalence of CKD was 1.6%, and the incidence of new CKD was 6.3%. Metabolic syndrome by NCEP ATP III definition was associated with the increased risk of CKD at baseline (adjusted odds ratio (OR) 2.48 and 95% confidence interval 1.33–4.62), and of developing new CKD at follow-up (adjusted OR 1.62 and 95% confidence interval 1.00–2.61). There was a significant graded relationship between the number of metabolic syndrome components present and risk of CKD. By contrast, metabolic syndrome by IDF definition was not associated with increased risk of CKD. These results suggest the relationship between CKD and metabolic syndrome in a Southeast Asian population is highly dependent on the criteria used to define metabolic syndrome.