Metabolic risk factors and renal disease

Abstract

Accumulating evidence supports that components of the metabolic syndrome coexist with both albuminuria and chronic kidney disease (CKD). The article by Tomaszewski et al. indicates that this interrelation exists in young obese men before overt renal or cardiovascular disease and also suggests that early treatment of hypertension is especially compelling to prevent the evolution of renal hyperfiltration to CKD.

Метаболічний Синдром І Ризик Хронічної Хвороби Нирок

“…Патологические нарушения в почках у больных с МС проявляются увеличением микрососудистой тубулярной атрофии, интерстициальным фиброзом и глобальным или сегментарным склерозом [29] (рис. 3).…”

Gangguan Ginjal terkait Obesitas pada Anak

“…3,14 Perubahan pada ginjal tersebut dapat menyebabkan inflamasi vaskular sistemik dan disfungsi endotel sehingga mengakibatkan cardiovascular-renal injury feedback loop yang progresif. 16 Hiperinsulinemia yang merupakan petanda penurunan sensitivitas insulin, memegang peran penting dalam patogenesis kelainan hemodinamik ginjal. 3 Penurunan sensitivitas insulin berperan meningkatkan tekanan arteriol eferen, sehingga terjadi peningkatan gradien tekanan transkapiler yang selanjutnya mengakibatkan hiperfiltrasi ginjal.…”

“…Hiperinsulinemia menyebabkan peningkatan laju ekskresi albumin urin (urinary albumin excretion-rate, U-AER), akibat peran angiotensin II yang meningkatkan NADPH oksidase/reactive oxygen species. 16,17 Akibat peningkatan aktivitas angiotensin II, terjadi hipertensi, peningkatan tekanan intraglomerular, proteinuria, serta apoptosis. 3 Hiperinsulinemia juga menyebabkan peningkatan sitokin proinflamasi intrarenal dan growth factor, seperti interleukin-1 (IL-1), IL-6, tumor necrosing factor-α (TNF-α), C-reactive protein (CRP), leptin, dan resistin.…”

“…3 Hiperinsulinemia juga menyebabkan peningkatan sitokin proinflamasi intrarenal dan growth factor, seperti interleukin-1 (IL-1), IL-6, tumor necrosing factor-α (TNF-α), C-reactive protein (CRP), leptin, dan resistin. 3,16 Peningkatan sitokin dan hipertensi menyebabkan pertumtbuhan sel ginjal berupa proliferasi sel mesangium, peningkatan produksi protein matriks ekstraselular, dan stimulasi ekspresi growth factor yang kemudian menyebabkan terjadinya hipertrofi glomerulus.…”

The obese child in the Intensive Care Unit. Update

“…104 Over the past decades, a significant increase in obesity-associated glomerulopathy has also been described, and this is a condition that is exclusively related to excess weight. 105 In addition to the known relationship between MS and the development of T2DM and cardiovascular disease, 58 there is evidence of a significant relationship between MS and obesity and albuminuria and end-stage renal disease (ESRD), [106][107][108] which has been observed to appear early in youth. 109 It has been proposed that adipocytes are the driving force of glomerular hyperfiltration in obese patients ( Figure 2).…”