[Association between metabolic syndrome and chronic kidney disease]

To explore the associations between the metabolic syndrome (MS) and chronic kidney disease (CKD) in patients admitted to our department.

A total of 525 consecutive patients were included in this cross-sectional study. Body height, weight, waist circumference, biochemical and serum lipid profile were measured. An oral glucose tolerance test (OGTT) was performed in patients without diabetes. CKD was defined by creatinine-based estimates of glomerular filtration rate (eGFR). The MS was defined according to IDF (International Diabetes Federation) definition.

(1) Serum creatinine (Cr) was significantly increased and the mean level of eGFR was significantly reduced in patients with MS compared to those without MS [Cr (93.81 +/- 31.06) micromol/L vs. (108.65 +/- 36.05) micromol/L, P < 0.001; eGFR (61.14 +/- 17.40) ml.min(-1).1.73 m(-2) vs. (73.64 +/- 17.03) ml.min(-1).1.73 m(-2), P < 0.001]. (2) eGFR decreased in proportion to increasing number of the MS components and was the lowest when patients had 5 components of the MS (P < 0.001). (3) Compared to patients without MS, the multivariate-adjusted (adjustment for age, sex, chronic heart failure and the use of ACEI or ARB medication) odds ration (95% CI) of CKD was 4.34 (95% CI: 2.77 - 6.81) in patients with MS. Compared to patients without any components or only with one component, the multivariate-adjusted odds ratios (95% CI) of CKD were 3.12 (1.41 - 6.89), 8.21 (3.78 - 17.82) and 14.72 (6.14 - 35.30) for those with 3, 4 and 5 components, respectively. In the multivariate models, elevated blood pressure, hyperglycemia, abdominal obesity and elevated triglycerides were significantly associated with an increased odds ratio (95% CI) of CKD, 1.75 (1.04 - 2.92), 1.98 (1.26 - 3.11), 2.42 (1.41 - 4.16) and 2.65 (1.68 - 4.19), respectively.

There are positive associations between MS, its components and CKD. The risk of CKD increased in proportion to increased number of MS components. Elevated blood pressure, hyperglycemia, abdominal obesity and hypertriglyceridemia also increase the risk of CKD.