Background: The influence of metabolic syndrome (MetS) on kidneys is related to many complications. We aimed to assess the association between MetS and chronic renal disease defined by a poor estimated glomerular filtration rate (eGFR) and/or the presence of microalbuminuria/macroalbuminuria. Methods: 149 patients (77 males/72 females) were enrolled in the study. Chronic renal disease was defined according to KDIGO 2012 criteria based on eGFR category and classified albuminuria. MetS was studied as a dichotomous variable (0 to 5 components) including hypertension, waist circumference, low HDL-cholesterol, high triglycerides, and high glucose. Results: The association between clustering MetS and both classified eGFR and classified albuminuria (x2 = 50.3, p = 0.001 and x2 = 26.9, p = 0.003 respectively) was found to be significant. The MetS presence showed an odds 5.3-fold (1.6–17.8) higher for low eGFR and 3.2-fold (1.2–8.8) higher for albuminuria in combination with the presence of diabetes mellitus, which also increased the risk for albuminuria by 3.5-fold (1.1–11.3). Albuminuria was significantly associated with high triglycerides, hypertension, high glucose (x2 = 11.8, p = 0.003, x2 = 11.4, p = 0.003 and x2 = 9.1, p = 0.01 respectively), and it was mildly associated with a low HDL-C (x2 = 5.7, p = 0.06). A significant association between classified eGFR and both high triglycerides and hypertension (x2 = 9.7, p = 0.04 and x2 = 16.1, p = 0.003 respectively) was found. Conclusion: The clustering of MetS was significantly associated with chronic renal disease defined by both classified eGFR and albuminuria. The definition of impaired renal function by classified albuminuria was associated with more MetS components rather than the evaluation of eGFR category. MetS may contribute to the manifestation of albuminuria in patients with diabetes mellitus.

BACKGROUND Metabolic disturbances including changes in serum calcium, magnesium or phosphate (P) influence the prevalence of type 2 diabetes mellitus (DM). We assessed the importance of serum P in elderly patients with type 2 DM vs non-diabetes mellitus (non-DM) in relation to renal function. AIM To determine the association between serum P and serum glucose or insulin resistance in diabetic and non-diabetic patients. METHODS One hundred-ten subjects with a mean age of 69.02 ± 14.3 years were enrolled. Twenty-nine of the participants had type 2 DM (26.4%). The incidence of hypertension, smoking and receiving vitamin D (vitD) derivates were recorded. The participants were classified by both estimated glomerular filtration rate (eGFR) and albuminuria categories according to the Kidney Disease Improving Global Outcomes 2012 criteria. RESULTS We divided the patients in two groups according to the P cut-off point related to DM value. A comparison between high and low P showed that body mass index 30.2 ± 6.3 vs 28.1 ± 4.6 ( P = 0.04), mean glucose 63.6 vs 50.2 ( P = 0.03), uric acid 6.7 ± 1.6 vs 6.09 ± 1.7 ( P = 0.05), mean intact-parathyroid hormone 68.06 vs 47.4 ( P = 0.001), systolic blood pressure 147.4 ± 16.7 vs 140.2 ± 16.1 ( P = 0.02), mean albuminuria 63.2 vs 50.6 ( P = 0.04) and eGFR 45.6 ± 22.1 vs 55.4 ± 21.5 ( P = 0.02) were significantly different. χ 2 tests showed a significant association between high P and DM, hypertension, receiving vitD, smoking and eGFR stage ( χ 2 = 6.3, P = 0.01, χ 2 = 3.9, P = 0.03, χ 2 = 6.9, P = 0.009, χ 2 = 7.04, P = 0.01 and χ 2 = 7.36, P = 0.04, respectively). The adjusted model showed that older age, female gender and increased body mass index were significant predictors of type 2 DM when entering the covariates. CONCLUSION High serum P contributes to vascular and metabolic disturbances in elderly patients with type 2 DM and renal impairment.

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Background: The triglycerides to high-density lipoprotein cholesterol (TG/HDL-C) ratio has been included in the potential indices for atherosclerosis in chronic kidney disease (CKD). In this study, we addressed the role of the TG/HDL-C ratio on CKD prediction defined by both classified estimated glomerular filtration rate (eGFR) and classified urinary albumin-to-creatinine ratio (UACR) in non-diabetic participants. Methods: One hundred and eighty-three subjects with a mean age 67.3 ± 15.6 years old were included. Our participants were classified in both eGFR and UACR categories according to the Kidney Disease Improving Global Outcomes 2012 criteria. Estimated pulse wave velocity (ePWV) was calculated using an equation from age and mean blood pressure. The TG/HDL-C ratio was calculated. X2 tests and adjusted models were applied using confounders. Results: The TG/HDL-C ratio was inversely associated with eGFR and positively with both UACR and ePWV. We divided our patients in two groups according to the found ROC curve of the TG/HDL-C ratio cut-off point, either with an eGFR of less or more than 60 mL/min/1.73 m2. X2 tests showed significant association between the high TG/HDL-C ratio and classified eGFR, and classified UACR and hypertension (x2 = 24.5, p = 0.001, x2 = 12.5, p = 0.002 and x2 = 12.6, p = 0.001, respectively). The adjusted model showed the high TG/HDL-C ratio to be an independent predictor for both a low eGFR and UACR (OR = 1.5, 1.2–1.9 and OR = 1.22, 1.02–1.47, respectively) in combination with old age and hypertension. Conclusion: The TG/HDL-C ratio was revealed to be a potential predictor for both a low eGFR and micro/macroalbuminuria in non-diabetic patients. The arterial stiffening was included in the main underlying pathophysiological mechanisms.

Background and objectives: Cardiac troponin T (cTnT) is independently associated with cardiovascular complications in patients with chronic kidney disease (CKD). The present study aimed to determine the factors related to cTnT levels in pre-dialysis CKD patients, which result to increased cardiovascular risk.Methods: A total of 147 patients, with a mean age of 69.1 ± 14.7 years old, were enrolled. These participants were classified to estimated glomerular filtration rate (eGFR) and albuminuria categories, according to the Kidney Disease Improving Global Outcomes 2012 criteria. The estimated pulse wave velocity (ePWV), as an index of arterial stiffness, was calculated using an equation, which included age and mean blood pressure. Coronary arterial disease (CAD) and left ventricular hypertrophy (LVH) were also recorded. The cTnT concentrations were measured by high-sensitivity immunoassay. The significant correlation between cTnT and different variables was determined, and the significant risk factors for high cTnT levels were defined.Results: A significant correlation was observed between cTnT serum concentrations and age, triglycerides/HDL-C, ePWV, glucose, phosphate (P), intact-parathyroid hormone (i-PTH), serum uric acid and albuminuria, although the association with eGFR was shown to be significantly inverse. The multifactorial model revealed that current smoking (p = 0.03, OR = 8.3, 1.15-60.3), CAD (p = 0.001, OR = 25.2, 5.6-113.6), low eGFR (p = 0.001, OR = 0.9, 0.8-0.9), high ePWV (p = 0.04, OR = 2.6, 1.0-6.8), and primary renal disease (p = 0.001, OR = 3.8, 1.7-8.5) are independent risk factors for elevated cTnT levels, after adjusting for age, gender, obesity and albuminuria.Conclusions: Arterial stiffness, smoking, primary renal disease and unregulated metabolic abnormalities may have an independent association between high cTnT levels and low eGFR in pre-dialysis CKD patients, with or without overt cardiovascular disease.