Pammer LM, Lamina C, Schultheiss UT, et al. - This prospective observational study shows a strong link between metabolic syndrome and cardiovascular disease, as well as an increased risk of mortality in patients with moderately severe chronic kidney disease (CKD), which was previously only predicted based on data from the general population.

• The study included 5,110 CKD patients from the German Chronic Kidney Disease study, with 3,284 (64.3%) of them having metabolic syndrome at baseline.

• Six hundred five patients died and 650 patients had major cardiovascular events during the 6.5-year follow-up period.

• Patients with metabolic syndrome had a higher risk of all-cause mortality and cardiovascular events after extended data adjustment.

• With an increasing number of metabolic syndrome components (increased waist circumference, glucose, triglycerides, hypertension, and decreased HDL cholesterol), the risk increased steadily: hazard ratio [HR] per component = 1.09 for all-cause mortality and 1.23 for cardiovascular events.

• In the presence of four or five components, this resulted in HRs ranging between 1.50 and 2.50.

• Analysis of individual metabolic syndrome components revealed that the glucose component increased the risk of all-cause mortality and cardiovascular events the most, followed by the HDL cholesterol and triglyceride components.