Metabolic Syndrome and Outcomes after Renal Intervention

Metabolic syndrome significantly increases the risk for cardiovascular disease and chronic kidney disease. The increased risk for cardiovascular diseases can partly be caused by a prothrombotic state that exists because of abdominal obesity. Multiple observational studies have consistently shown that increased body mass index as well as insulin resistance and increased fasting insulin levels is associated with chronic kidney disease, even after adjustment for related disorders. Metabolic syndrome appears to be a risk factor for chronic kidney disease, likely due to the combination of dysglycemia and high blood pressure. Metabolic syndrome is associated with markedly reduced renal clinical benefit and increased progression to hemodialysis following endovascular intervention for atherosclerotic renal artery stenosis. Metabolic syndrome is associated with inferior early outcomes for dialysis access procedures.

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Insulin Resistance in Patients with Chronic Kidney Disease

Journal of Biomedicine and Biotechnology ◽

10.1155/2012/691369 ◽

2012 ◽

Vol 2012 ◽

pp. 1-12 ◽

Cited By ~ 31

Author(s):

Min-Tser Liao ◽

Chih-Chien Sung ◽

Kuo-Chin Hung ◽

Chia-Chao Wu ◽

Lan Lo ◽

...

Keyword(s):

Oxidative Stress ◽

Insulin Resistance ◽

Metabolic Syndrome ◽

Chronic Kidney Disease ◽

Kidney Disease ◽

Elevated Serum ◽

Cytokine Signaling ◽

Protein Energy Wasting ◽

The Metabolic Syndrome ◽

Increased Risk

Metabolic syndrome and its components are associated with chronic kidney disease (CKD) development. Insulin resistance (IR) plays a central role in the metabolic syndrome and is associated with increased risk for CKD in nondiabetic patients. IR is common in patients with mild-to-moderate stage CKD, even when the glomerular filtration rate is within the normal range. IR, along with oxidative stress and inflammation, also promotes kidney disease. In patients with end stage renal disease, IR is an independent predictor of cardiovascular disease and is linked to protein energy wasting and malnutrition. Systemic inflammation, oxidative stress, elevated serum adipokines and fetuin-A, metabolic acidosis, vitamin D deficiency, depressed serum erythropoietin, endoplasmic reticulum stress, and suppressors of cytokine signaling all cause IR by suppressing insulin receptor-PI3K-Akt pathways in CKD. In addition to adequate renal replacement therapy and correction of uremia-associated factors, thiazolidinedione, ghrelin, protein restriction, and keto-acid supplementation are therapeutic options. Weight control, reduced daily prednisolone dosage, and the use of cyclosporin decrease the risk of developing new-onset diabetes after kidney transplantation. Improved understanding of the pathogenic mechanisms underlying IR in CKD may lead to more effective therapeutic strategies to reduce uremia-associated morbidity and mortality.

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Metabolic Syndrome and Insulin Resistance as Risk Factors for Development of Chronic Kidney Disease and Rapid Decline in Renal Function in Elderly

The Journal of Clinical Endocrinology & Metabolism ◽

10.1210/jc.2011-2658 ◽

2012 ◽

Vol 97 (4) ◽

pp. 1268-1276 ◽

Cited By ~ 63

Author(s):

Hui-Teng Cheng ◽

Jenq-Wen Huang ◽

Chih-Kang Chiang ◽

Chung-Jen Yen ◽

Kuan-Yu Hung ◽

...

Keyword(s):

Risk Factors ◽

Insulin Resistance ◽

Metabolic Syndrome ◽

Chronic Kidney Disease ◽

Renal Function ◽

Kidney Disease ◽

Rapid Decline

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Increased Risk of Chronic Kidney Disease in Elderly with Metabolic Syndrome and High Levels of C-Reactive Protein: Kahrizak Elderly Study

Kidney & Blood Pressure Research ◽

10.1159/000274046 ◽

2009 ◽

Vol 32 (6) ◽

pp. 457-463 ◽

Cited By ~ 18

Author(s):

Hossein Fakhrzadeh ◽

Maryam Ghaderpanahi ◽

Farshad Sharifi ◽

Zohre Badamchizade ◽

Mojde Mirarefin ◽

...

Keyword(s):

Metabolic Syndrome ◽

Chronic Kidney Disease ◽

Kidney Disease ◽

C Reactive Protein ◽

Reactive Protein ◽

Increased Risk

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Association of Metabolic Syndrome in Nondiabetic Patients with Increased Risk for Chronic Kidney Disease: The Fat Lady Sings

Journal of the American Society of Nephrology ◽

10.1681/asn.2005050513 ◽

2005 ◽

Vol 16 (7) ◽

pp. 1880-1882 ◽

Cited By ~ 9

Author(s):

John R. Sedor ◽

Jeffrey R. Schelling

Keyword(s):

Metabolic Syndrome ◽

Chronic Kidney Disease ◽

Kidney Disease ◽

Increased Risk

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The obese patient (metabolic syndrome)

10.1093/med/9780199592548.003.0168 ◽

2015 ◽

Author(s):

Maarit Korkeila ◽

Bengt Lindholm ◽

Peter Stenvinkel

Keyword(s):

Risk Factors ◽

Metabolic Syndrome ◽

Chronic Kidney Disease ◽

Kidney Disease ◽

Overweight And Obesity ◽

Blood Cholesterol ◽

Long Term Effects ◽

Reverse Epidemiology ◽

Increased Risk

Overweight and obesity cause pathophysiological changes in renal function and increase the risk for chronic kidney disease in otherwise healthy subjects. This should not be a surprise as the risk factors for metabolic syndrome largely overlap with those for chronic kidney disease. Intentional weight loss has beneficial effects on risk factors, but long term effects are less clear. Bariatric surgery does seem to achieve rapid benefits on blood pressure and proteinuria as well as on other aspects of metabolic syndrome, but its long term implications for kidney function are less clear cut as there may be an increased risk of nephrolithiasis, and possibly AKI and other complications.Obesity in haemodialysis patients is one of those paradoxical examples of reverse epidemiology where a factor associated with negative outcomes in the general population is associated with better outcomes in dialysis patients. The same is true for high blood cholesterol values. Interpretation is complicated by complex competing outcomes and confounders.

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Chronic Kidney Disease in Non-Diabetic Older Adults: Associated Roles of the Metabolic Syndrome, Inflammation, and Insulin Resistance

PLoS ONE ◽

10.1371/journal.pone.0139369 ◽

2015 ◽

Vol 10 (10) ◽

pp. e0139369 ◽

Cited By ~ 14

Author(s):

Andrea R. Zammit ◽

Mindy J. Katz ◽

Carol Derby ◽

Markus Bitzer ◽

Richard B. Lipton

Keyword(s):

Insulin Resistance ◽

Older Adults ◽

Metabolic Syndrome ◽

Chronic Kidney Disease ◽

Kidney Disease ◽

The Metabolic Syndrome

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PS 11-79 METABOLIC SYNDROME, INSULIN RESISTANCE IS ASSOCIATED WITH RAPID DECLINE OF KIDNEY FUNCTION AND INCIDENT CHRONIC KIDNEY DISEASE OVER 10 YEARS IN THE KOREAN GENOME AND EPIDEMIOLOGY STUDY (KoGES)

Journal of Hypertension ◽

10.1097/01.hjh.0000500908.66768.b3 ◽

2016 ◽

Vol 34 (Supplement 1) ◽

pp. e354

Author(s):

Ji Hye Huh ◽

Jang Young Kim ◽

Jae Seok Kim ◽

EunHee Choi

Keyword(s):

Insulin Resistance ◽

Metabolic Syndrome ◽

Chronic Kidney Disease ◽

Kidney Disease ◽

Kidney Function ◽

Rapid Decline ◽

Epidemiology Study ◽

Incident Chronic Kidney Disease

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INSULIN RESISTANCE AND CHRONIC KIDNEY DISEASE IN PATIENTS WITH TYPE 1 DIABETES MELLITUS AT MEDICINE DEPARTMENT OF GMC, BETTIAH, BIHAR

10.36106/ijsr/9227019 ◽

2020 ◽

pp. 1-2

Author(s):

Sumit Kumar ◽

Dharmendra Prasad ◽

Parshuram Yugal ◽

Debarshi Jana

Keyword(s):

Diabetes Mellitus ◽

Insulin Resistance ◽

Chronic Kidney Disease ◽

Type 1 Diabetes ◽

Kidney Disease ◽

Glycosylated Hemoglobin ◽

Diabetic Patients ◽

Medicine Department ◽

Increased Risk

Background and Aims : Diabetes mellitus (DM) is a chronic disease which can evolve towards devastating micro- and macrovascular complications. DM is the most frequent cause of chronic kidney disease (CKD). Insulin resistance plays an important role in the natural history of type 1 diabetes. The purpose of the study was to determine the prevalence of CKD in T1DM and the correlation with insulin resistance (IR) in patients with CKD. Materials and Methods : The study was conducted over a period of two years (2014–2015) and included patients with DM admitted in Medicine Department of ANMMCH, Gaya, Bihar. The study design was an epidemiological, transversal, noninterventional type. Finally, the study group included 200 subjects with type 1 DM. Insulin resistance (IR) was estimated by eGDR. The subjects with eGDR ≤ 7.5mg/kg/min were considered with insulin resistance. Results : CKD was found in 44% of the patients. Analyzing statistically the presence of CKD, we found highly significant differences between patients with CKD and those without CKD regarding age and sex of the patients, the duration of diabetes, glycosylated hemoglobin (HbA1c), the estimated glucose disposal rate (eGDR), and the presence of hypertension, dyslipidemia, and hyperuricaemia. In patients with CKD, age and diabetes duration are significantly higher than in those who do not have this complication. CKD is more frequent in males than in females (50.9% men versus 34.5% women, ). From the elements of metabolic syndrome, high blood pressure, hyperuricemia, and dyslipidemia are significantly increased in diabetic patients with CKD. eGDR value (expressed as mg•kg−1•min−1) is lower in patients with CKD than in those without CKD (15.92 versus 6.42, ) indicating the fact that patients with CKD show higher insulin resistance than those without CKD. Conclusions. This study has shown that insulin resistance is associated with an increased risk of CKD, but, due to the cross-sectional design, the causal relationship cannot be assessed.

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