Possible Link Between Metabolic Syndrome and Chronic Kidney Disease in the Elderly

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. Elderly patients with CKD have high rates of comorbid conditions, including cardiovascular disease and CKD-related complications. 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 in the elderly. 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 an angiotensin receptor blocker. An improved understanding of the mechanism responsible for the association between MetS and renal damage and large, randomized controlled trials of treatments designed to prevent the development and progression of CKD should be helpful in determining the treatment regimens directed at cardiovascular and renal protection in the elderly.