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SummaryBackgroundMetabolic syndrome increases the risk of cardiovascular disease (CVD) and all-cause mortality in the general population.AimsTo investigate whether metabolic syndrome affects CVD and all-cause mortality in chronic haemodialysis patients.MethodsThis prospective, observational cohort study was carried out at Peking university third hospital from June 2006 to June 2010. Baseline anthropometric and laboratory parameters were evaluated, and causes and times of mortality were documented. Nutritional status of the patients was assessed using subject global assessment (SGA) and serum albumin levels.ResultsOf 162 haemodialysis patients recruited, five were lost to follow-up, leaving 157 in the final cohort, who were followed for 36−42 months. Mean age was 62 ± 11 years and 55.4% were men. Forty-six patients (30%) had metabolic syndrome. In the metabolic syndrome versus the non-metabolic syndrome group, there were fewer patients with malnutrition (by SGA) (15.2% vs. 55.0%; P < 0.001), but there were no significant differences in CVD mortality (8.7% vs. 10.8%; P = 0.9) or all-cause mortality (15.2% vs. 22.5%; P = 0.39), nor in mean observed survival time (30.8 ± 7.3 vs. 29.8 ± 8.5 months; P = 0.49) or total survival time (67 ± 43 vs. 78 ± 48 months; P = 0.20). Cox regression analysis showed that independent mortality risk factors were pre-existing CVD, age more than or equal to 66 years and serum albumin less than 37g/L (indicating malnutrition).ConclusionMetabolic syndrome was associated with a better nutritional status, but not with CVD or all-cause mortality in the haemodialysis patients in this prospective cohort study.