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Comparative Proteomic Analysis of Whole Kidney, Medulla, and Cortical Tubules in Diabetic Pathogenesis of Kidney Injury in Mice
Published on: May 2, 2025
Obesity and insulin resistance as risk factors for chronic kidney disease
Adam Whaley-Connell1, Brian S Pavey, Aneesa Afroze
1Department of Internal Medicine, Division of Nephrology, University of Missouri School of Medicine, Columbia, MO, USA. whaleyconnella@health.missouri.edu
Insights
Cardiometabolic syndrome, a cluster of metabolic issues, significantly elevates the risk of kidney disease. Aggressively managing metabolic syndrome risk factors is crucial to prevent progressive loss of kidney function.
Area of Science:
- Nephrology
- Cardiology
- Endocrinology
Background:
- Cardiometabolic syndrome involves metabolic and vascular dysregulation.
- It is characterized by insulin resistance, obesity, dyslipidemia, and hypertension.
- Microalbuminuria signifies systemic endothelial dysfunction and predicts kidney disease progression.
Purpose of the Study:
- To highlight the link between cardiometabolic syndrome and kidney disease.
- To emphasize the role of microalbuminuria as a marker of endothelial dysfunction.
- To underscore the importance of managing metabolic syndrome risk factors for renal health.
Main Methods:
- Review of existing literature on cardiometabolic syndrome and renal outcomes.
- Analysis of the clinical components of cardiometabolic syndrome.
- Examination of the progression from microalbuminuria to overt kidney disease.
Main Results:
- Cardiometabolic syndrome components collectively increase cardiovascular and renal risk.
- Visceral obesity and insulin resistance are key drivers of microalbuminuria.
- Progression to macroalbuminuria indicates evident kidney disease.
Conclusions:
- Aggressive management of cardiometabolic syndrome risk factors is essential.
- Nonpharmacologic and pharmacologic interventions can prevent or delay renal function loss.
- Early intervention is critical to avert chronic kidney disease.
Abstract:
The cardiometabolic syndrome is a state of metabolic and vascular dysregulation. The cardiometabolic syndrome is clinically composed of a cluster of metabolic abnormalities including insulin resistance/hyperinsulinemia, central/visceral obesity, dyslipidemia, hypertension, microalbuminuria, fibrinolytic and inflammatory abnormalities, endothelial dysfunction, oxidative stress, and hypercoagulability, which collectively lead to an increased risk of cardiovascular and renal outcomes. The development of microalbuminuria is now accepted as a marker of systemic endothelial dysfunction and, if it progresses to macroalbuminuria (i.e., >200 mg/d albuminuria), then kidney disease is evident. Collectively, visceral obesity, insulin resistance/hyperinsulinemia, and other components of the cardiometabolic syndrome lead to an increased risk of microalbuminuria and progressive loss of renal function. Hence, aggressive management of risk factors for the metabolic syndrome, nonpharmacologic and pharmacologic, is essential to prevent or delay the progressive loss of renal function and chronic kidney disease.
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