The Metabolic Syndrome and Chronic Kidney Disease in U.S. Adults

Chen, Jing; Muntner, Paul; Hamm, L. Lee; Jones, Daniel W.; Batuman, Vecihi; Fonseca, Vivian; Whelton, Paul K.; He, Jiang

doi:10.7326/0003-4819-140-3-200402030-00007

Cited by 1,188 publications

(785 citation statements)

References 22 publications

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“…Indeed, the frequency of microalbuminuria in the general population has been shown to increase with the degree of obesity. 29 Its frequency was significantly higher in subjects with MS than in those without MS suggesting that in children, as in adults, 30 microalbuminuria is associated with MS. Obese children with MS also had higher concentrations of PAI-1 and uric acid which together with microalbuminuria explained 10.6% of the variance of the MS. This proportion is similar to the 7.4% of the total variance of MS explained by an 'inflammatory factor' in nondiabetic individuals participating in the Insulin Resistance Atherosclerosis Study.…”

Section: Discussionmentioning

confidence: 91%

Metabolic syndrome in obese Caucasian children: prevalence using WHO-derived criteria and association with nontraditional cardiovascular risk factors

et al. 2006

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Objective: Studies on the prevalence of metabolic syndrome (MS) in European obese children using child-based criteria are scanty. Moreover, it is unknown if nontraditional cardiovascular disease (CVD) risk factors are associated with the MS at this early age in these subjects. Design and subjects: We studied the prevalence of the MS in 588 Caucasian obese children and adolescents by devising a World Health Organization derived definition and child-specific criteria, whose deviation from normalcy was based on an age, sex, and ethnically comparable control group of 1363 subjects. In a subgroup of 206 obese children, we investigated the association of the MS with nontraditional CVD risk factors. Measurements: Fasting blood samples for glucose and lipids measurements were taken in both control and obese children. In addition, the obese children underwent an oral glucose tolerance test. In the subgroup of 206 obese children, albumin excretion rate , plasma uric acid, fibrinogen, plasminogen activator inhibitor type 1(PAI-1), C-reactive protein, interleukin 6 and white blood cells were also measured. Results: The prevalence of MS was 23.3%. A similar prevalence of 23% of MS was recorded in the subgroup of 206 obese children in whom measurements of nontraditional CVD risk factors were available. After adjustment for the degree of obesity, subjects with MS had significantly higher uric acid (6.670.23 vs 6.170.12 mg/dl, Po0.0001) and PAI-1 plasma concentrations (231.4725.50 vs 214.3712.96 ng/ml, Po0.05) and a higher frequency of microalbuminuria (37 vs 20%, Po0.05) than those without MS. Microalbuminuria, uric acid and PAI-1 explained 10.6% of the variance of MS. Conclusion: Approximately, a quarter of Caucasian obese children have the MS. The association of MS with several nontraditional risk factors for CVD early in life suggests a heightened CVD risk in these individuals.

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Section: Discussionmentioning

confidence: 91%

Metabolic syndrome in obese Caucasian children: prevalence using WHO-derived criteria and association with nontraditional cardiovascular risk factors

et al. 2006

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“…15 Obesity is linked to metabolic syndrome, 25 a condition associated with chronic kidney disease. 17 While the presence of metabolic syndrome was not assessed directly, it is plausible that syndrome components (diabetes, hypertension, hyperlipidemia, glucose intolerance, or insulin resistance) may have acted in concert to increase risk, though parsing the relevance of individual factors is challenging. Data from the ACS-NSQIP found that diabetics were 1.3 (for those on oral therapy) to 1.7 (for those on insulin therapy) times more likely to develop postoperative AKI, 16 a degree of increased risk comparable with our findings.…”

Section: Discussionmentioning

confidence: 99%

Acute kidney injury following total joint arthroplasty: retrospective analysis

Weingarten

Gurrieri

Jarett

et al. 2012

Can J Anesth/J Can Anesth

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Introduction Postoperative acute kidney injury (AKI) following arthroplasty has not been well studied. Our aim was to identify factors associated with increased risk of AKI. Methods The medical records for adult patients who underwent elective total joint arthroplasty during June 1, 2007 to May 31, 2010 at the Mayo Clinic were reviewed to identify patients with normal preoperative kidney function who experienced perioperative AKI, defined as an increase in serum creatinine (sCr) by 26.4 lmolÁL -1 . For each AKI case, two controls were identified and matched for age, sex, and type of operation. Medical records were abstracted for demographics, comorbid conditions, and preoperative, intraoperative, and postoperative variables. Conditional logistic regression analyses were performed to identify risk factors for AKI. Results Of the 9,171 patients who underwent joint replacement operations, 167 with normal preoperative renal function developed AKI with a median [25 th , 75 th ] increase in sCr of 35.4 [26.4, 44.2] lmolÁL -1 . No patient required dialysis. A higher than normal body mass index, diabetes mellitus, the number of baseline antihypertensive medications, cerebral or peripheral vascular disease, use of general anesthesia, and perioperative blood transfusions were independently associated with risk for AKI. Hospital length of stay and intensive care admissions were greater in AKI patients, and in 12.0% of patients, sCr remained at least 26.4 lmolÁL -1 higher than preoperative baseline at least three months after surgery. Conclusion In this case-control investigation, we identified several factors associated with the development of postoperative AKI. Recognition of these risk factors could allow for the adoption of perioperative renal protective strategies in patients undergoing arthroplasty.

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“…16,17 Insulin resistance has been reported to increase the risk of CKD. 18,19 Chen et al 18,19 determined that metabolic syndrome 19 and insulin resistance estimated by a homeostasis model assessment 18 were associated with an increased CKD risk in participants in the NHANES III study.…”

Section: Discussionmentioning

confidence: 99%

Very low-grade albuminuria reflects susceptibility to chronic kidney disease in combination with cardiovascular risk factors

et al. 2010

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Low-grade albuminuria has been proposed as a cardiovascular risk factor that is below the conventional cut-off point for microalbuminuria, which has been previously identified as a marker for cardiovascular disease and chronic kidney disease (CKD). Metabolic syndrome has also been shown to be related with microalbuminuria and CKD. We assessed the relationship among low-grade albuminuria, CKD and metabolic syndrome among 5998 non-diabetic subjects. The subjects were divided into six groups: subjects with urine albumin-to-creatinine ratio (UACR) o30 mg g À1 were divided into five groups in accordance with their UACR values, and subjects with 30pUACR o300 mg g À1 were allocated to the microalbuminuria group. The prevalence of CKD increased in parallel with increasing UACR values and greater numbers of metabolic syndrome characteristics, which were in turn associated with a reduced UACR cut-off point for an increased prevalence of CKD. Among the subjects with metabolic syndrome, UACR values above 10.2 mg g À1 were related to increased CKD prevalence (odds ratio (OR): 2.63, 95% confidence interval (CI) 1.11-6.24), as were values of 30 mg g À1 among those with 1 or 2 components of metabolic syndrome (OR: 2.98, 95% CI 1.83-4.83); elevated UACR was not observed to increase the risk of CKD in subjects who had no components of metabolic syndrome. The cut-off point varied in subjects with various cardiovascular risk profiles such as serum uric acid level, gender or hypertension. Very low levels of albuminuria were associated with increased CKD prevalence. The UACR cut-off point for increased CKD risk varied according to the risk profile, including the number of metabolic syndrome components.

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The Metabolic Syndrome and Chronic Kidney Disease in U.S. Adults

Abstract: These findings suggest that the metabolic syndrome might be an important factor in the cause of chronic kidney disease.

Cited by 1,188 publications

References 22 publications

Metabolic syndrome in obese Caucasian children: prevalence using WHO-derived criteria and association with nontraditional cardiovascular risk factors

Metabolic syndrome in obese Caucasian children: prevalence using WHO-derived criteria and association with nontraditional cardiovascular risk factors

Acute kidney injury following total joint arthroplasty: retrospective analysis

Very low-grade albuminuria reflects susceptibility to chronic kidney disease in combination with cardiovascular risk factors

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