Metabolic Syndrome and Chronic Renal Disease

Abstract

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.

The Effect of Lipotoxicity on Renal Dysfunction in a Nonobese Rat Model of Metabolic Syndrome: A Urinary Proteomic Approach

“…Microalbuminuria is considered a traditional risk marker for the diagnosis and prognosis of declining renal function. Some studies demonstrated an association between insulin resistance and microalbuminuria, and MetS may contribute to the manifestation of albuminuria in patients with diabetes mellitus [24, 25].…”

Critical Role for AMPK in Metabolic Disease-Induced Chronic Kidney Disease

“…CKD is associated with metabolic syndrome (MetS), a cluster of metabolic disorders, including hypertension, hyperlipidemia, hyperglycemia, and obesity [3]. MetS contributes to the appearance of albuminuria, the first sign of kidney disease in patients with diabetes [4][5][6]. Moreover, accumulating studies report that obesity is an independent risk factor of CKD [7][8][9].…”

Effects of metabolic syndrome on renal function after radical nephrectomy in patients with renal cell carcinoma

“…CKD, regardless of the causes, and RCC share many risk factors, including age, gender, smoking, hypertension and diabetes mellitus, and these are also related to MetS components. [27] In a large cohort study with nearly 1,200, 000 adults with eGFR< 30 ml/min/1.73 m 2 and a two-fold risk of RCC compared to those with 60-89ml/min/1.73 m, 28 CKD itself was reported to be an independent risk factor for RCC. In order to clarify the effects of MetS and simplify the study design, we controlled for age and gender.…”

“…Even the MetS-related abnormalities such as hypertension and diabetes mellitus are shown to increase the risk of CKD after nephrectomy. [27] Therefore, MS may re ect a more comprehensive presentation of individuals with CKD risk than each individual component of MS. When Kriegmair et al 12 evaluated the impact of MetS and each of the single components of MetS on outcomes of patients with RCC, the results of Kaplan-Meier and log-rank analysis revealed that MetS was signi cantly associated with a shorter PFS (p=0.018), whereas no signi cant differences were found in the effects of diabetes mellitus, BMI, hypertension and hypertriglyceridemia on the outcomes.…”