Possible Link between Metabolic Syndrome and Chronic Kidney Disease in the Development of Cardiovascular Disease

Abstract

Metabolic syndrome (MetS) is a clinical syndrome that consists of visceral obesity, dyslipidemia, hypertension, and impaired insulin sensitivity. Although individual components of MetS have been implicated in the development of chronic kidney disease (CKD), few studies have examined the effect of combinations of the components of MetS on the development of CKD and cardiovascular disease (CVD). The prevalence of MetS is increasing worldwide in both developing and developed countries, and early detection and treatment of MetS would be a cost-effective strategy for preventing the development of CKD. Visceral obesity and insulin resistance are two important features of MetS that may be associated with renal damage. Lifestyle modifications, including caloric restriction and exercise, are necessary to treat MetS. Initial antihypertensive therapy should consist of an angiotensin-converting enzyme inhibitor or angiotensin receptor blocker. An improved understanding of the mechanism responsible for the association between MetS and renal damage should be helpful in determining the treatment regimens directed at cardiovascular and renal protection.

Figure 1

Hemodynamic consequences of obesity leading to hyperfiltration and hypertension.

Figure 2

Complex pathogenesis of chronic kidney disease (CKD) and cardiovascular disease (CVD) [50].

Figure 3

Kapla-Meier curves for all-cause mortality stratified by no chronic kidney disease (CKD)/no cardiovascular disease (CVD), prevalent CKD, CVD, and CVD + CKD from the KEEP Program [54].