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Chronic Kidney Disease (CKD) in Metabolic Syndrome (MS): Results from Korean National Health and Nutrition Examination Survey (Korean NHANES)
M. A. Yu*1, J. H. Ryu1, D. R. Ryu1, S. J. Kim1, K. B. Choi1, K. I. Yoon1, D. H. Kang1; 1Nephrology, Ewha Womans University College of Medicine, Seoul, South Korea

Introduction:
Incidence of end stage renal disease (ESRD) in Korea is increasing more than 10% annually, which takes the 11th rank in the world according to USRDS in 2006. To better understand the clinical implication of MS as a risk factor of CKD and its characteristics which is possibly different in each country with different ethnic background and life style, we performed a cross-sectional study in non-institutionalized Korean civilian using the data of Korean NHANES in 2001.

Methods:
Of 7,918 participants, 5,715 at age between 20 and 79 years were available for analysis for the prevalence of CKD (defined as dipstick proteinuria or a reduced GFR less than 60 ml/min per 1.73m2 by MDRD formula). MS was diagnosed by original NCEP-ATP III criteria (waist circumference, 102 cm for men and 88 cm for women, NCEP-O) or NCEP-ATP III with the Asia-Pacific abdominal obesity criteria (90 cm for men, 80 cm for women, NCEP-AP).

Results:
Overall, 33.9%, 16.2%, 33.1%, 49.0%, 9.9% and 33.6% of the participants had elevated blood pressure, high plasma glucose, high triglyceride, low HDL-cholesterol and abdominal obesity by NCEP-O and NCEP-AP, respectively. The prevalence of MS was 18.0% by NCEP-O and 25.7% by NECP-AP. CKD was seen in 8.7% of subjects. In subjects with MS, the prevalence of CKD was higher (18.3 vs. 6.7%, p=0.0001) with a lower GFR (74.2 vs. 80.1 ml/min/1.73 m2, p<0.0001) compared to subjects without MS. There was a significant graded increase in the prevalence of CKD with number of components of MS. The multivariate-adjusted odds ratio of CKD in subjects with MS compared with subjects without MS was 1.50 (95% CI, 1.19 to 1.90, p<0.0001). Compared with subjects with 0 or 1 components, subjects with 5 components of MS had multivariate-adjusted odds ratio of 6.58 (CI, 4.07 to 7.74, p=0.001).

Conclusion:
Metabolic syndrome is a significant determinant of CKD in Korean general population. Prevalence of low HDL-cholesterol was higher compared to studies from the US and Japan with a variable prevalence of CKD.

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