Increased Risk of Chronic Kidney Diseases in Patients with Metabolic Syndrome: A 3-year Prospective Cohort Study.

Abstract

The relationship of metabolic syndrome (MS) and its components with incident chronic kidney disease (CKD) and rapid decline of estimated glomerular filtration rate (eGFR) was investigated. A total of 10 140 patients participating in the epidemiological study (Risk Evaluation of Cancers in Chinese Diabetic Individuals, REACTION) of risk factors of type 2 diabetes in China were followed up for 3 years, with MS being diagnosed by adult treatment panel III (ATPIII) combined with waist circumference in Asian population and renal function being evaluated by eGFR <60 mL·min-1(1.73 m2)-1 and rapid decline of eGFR ≤30%. The results showed that as compared with the non-MS group, the adjusted odds ratios (ORs) of CKD and rapid decline of eGFR were 1.64 (OR: 1.64; 95% CI: 1.20-2.25, P<0.05) and 1.23 (OR: 1.23; 95% CI: 1.05-1.43, P<0.05) respectively in MS group. With the increase in the number (0, 1, 2, 3 and ≥4) of MS components, the prevalence of CKD was 1.42%, 1.44%, 2.80%, 3.42%, and 4.03% (P<0.001), respectively. The ORs of incident CKD were 1.67 (OR: 1.67; 95% CI: 1.22-2.27, P<0.05) for high TG, 1.50 (OR: 1.50; 95% CI: 1.10-2.05, P<0.05) for low HDL-C, and 1.39 (OR: 1.39; 95% CI: 1.02-1.91, P<0.05) for hyperglycemia. The risk for developing incident CKD was higher in the group with the highest HOMA-IR than in the group with the lowest HOMA-IR (OR: 1.83; 95% CI: 1.16-2.89, P<0.05). It is suggested that MS is an independent risk factor for incident CKD. The occurrence and development of CKD is closely related to insulin resistance.