Glomerular function and metabolic syndrome in Venezuelan adults with cardiometabolic risk factors treated in a primary health care center
DOI:
https://doi.org/10.31053/1853.0605.v76.n3.23677Keywords:
metabolic syndrome, glomerular filtration rate, proteinuriaAbstract
Introduction: The relationship of the metabolic syndrome (MS) and its components with the reduced glomerular filtration rate and proteinuria is not yet widely elucidated. The aim of the study was to associate the estimated glomerular filtration rate (eGFR) and proteinuria to MS and its individual components in adults with cardiometabolic risk factors, who attended a public health center in the municipality of San Diego, Carabobo State, Venezuela.
Methods: Descriptive and cross-sectional study (n=176 individuals). Weight, height, waist circumference, body fat percentage and blood pressure were measured; serum glucose, creatinine, urea, ureic nitrogen, total cholesterol, low (LDLc) and high (HDLc) density lipoprotein cholesterol, triglycerides and glycosylated hemoglobin A1C in whole blood were determined; the presence of proteinuria was determined in partial urine. The eGFR was estimated by equations and the body mass index (BMI) was calculated.
Results: The frequency of MS was significantly higher among patients with CKD (eGFR < 60 mL/min/m2), mildly reduced eGFR (60-89 mL/min/m2), hyperfiltration or proteinuria. The risks of mildly reduced eGFR and protenuria were significantly associated with elevated fasting blood glucose, low HDLc and MS, with and without adjustment for sex, age and BMI. When adjusted for the diabetic condition, only the risk of proteinuria remained associated with MS and elevated blood pressure. The risk of hyperfiltration was not associated with MS.
Conclusion: The reduction in estimated glomerular function and proteinuria were associated with MS and its individual components. Other studies that confirm the results are required.
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Drawz P, Rahman M. Chronic kidney disease. Ann Intern Med 2015:162(11):ITC1-16.
Jha V, García-García G, Iseki K, Li Z, Naicker S, Plattner B et al. Chronic kidney disease: global dimension and perspectives. Lancet 2013; 382(9888):260-272.
Ministerio del Poder Popular para la Salud. Anuario de Mortalidad 2013. Caracas, Venezuela: Ministerio del Poder Popular para la Salud; 2017.
Ardhanari S, Alpert MA, Aggarwal K. Cardiovascular disease in chronic kidney disease: risk factors, pathogenesis, and prevention. Adv Perit Dial 2014;30:40-53.
Alberti KG, Eckel RH, Grundy SM, Zimmet PZ, Cleeman JI, Donato KA et al. Harmonizing the metabolic syndrome: a joint interim statement of the International Diabetes Federation Task Force on Epidemiology and Prevention; National Heart, Lung, and Blood Institute; American Heart Association; World Heart Federation; International Atherosclerosis Society; and International Association for the Study of Obesity. Circulation 2009;120(16):1640-5.
Chen J, Kong X, Jia X, Li W, Wang Z, Cui M et al. Association between metabolic syndrome and chronic kidney disease in a Chinese urban population. Clin Chim Acta 2017;470:103-8.
Onat A, Hergenç G, Uyarel H, Ozhan H, Esen AM, Karabulut A et al. Association between mild renal dysfunction and insulin resistance or metabolic syndrome in a random nondiabetic population sample. Kidney Blood Press Res 2007;30(2):88-96.
Hu W, Wu XJ, Ni YJ, Hao HR, Yu WN, Zhou HW. Metabolic syndrome is independently associated with a mildly reduced estimated glomerular filtration rate: a cross-sectional study. BMC Nephrol 2017;18(1):192.
Monami M, Pala L, Bardini G, Francesconi P, Cresci B, Marchionni N et al. Glomerular hyperfiltration and metabolic syndrome: results from the FIrenze-BAgno A Ripoli (FIBAR) Study. Acta Diabetol 2009;46(3):191-6.
Okada R, Yasuda Y, Tsushita K, Wakai K, Hamajima N, Matsuo S. The number of metabolic syndrome components is a good risk indicator for both early- and late-stage kidney damage. Nutr Metab Cardiovasc Dis 2014; 24(3):277-285.
Henry RM, Kostense PJ, Bos G, Dekker JM, Nijpels G, Heine RJ et al. Mild renal insufficiency is associated with increased cardiovascular mortality: The Hoorn Study. Kidney Int 2002;62(4):1402-7.
Fox CS, Larson MG, Leip EP, Culleton B, Wilson PW, Levy D. Predictors of new-onset kidney disease in a community-based population. JAMA 2004;291(7):844-50.
Park M, Yoon E, Lim YH, Kim H, Choi J, Yoon HJ. Renal hyperfiltration as a novel marker of all-cause mortality. J Am Soc Nephrol 2015;26(6):1426-33.
Kwon Y, Han K, Kim YH, Park S, Kim DH, Roh YK et al. Dipstick proteinuria predicts all-cause mortality in general population: A study of 17 million Korean adults. PLoS One 2018;13(6):e0199913.
O'Brien E, Asmar R, Beilin L, Imai Y, Mancia G, Mengden T et al. Practice guidelines of the European Society of Hypertension for clinic, ambulatory and self blood pressure measurement. J Hypertens 2005;23(4):697-701.
World Health Organization. Physical status: the use and interpretation of anthropometry. Report of a WHO Expert Committee. World Health Organ Tech Rep Ser 1995;854:1-452.
Levey AS, Stevens LA, Schmid CH, Zhang YL, Castro AF, Feldman HI et al. A new equation to estimate glomerular filtration rate. Ann Intern Med 2009;150(9):604-612.
National Kidney Foundation. K/KDOQI Clinical practice guidelines for chronic kidney disease evaluation, classification and stratification. Am J Kidney Dis 2002;39(2 Suppl 1):S1-266.
Chobanian AV, Bakris GL, Black HR, Cushman WC, Green LA, Izzo JL Jr et al. The seventh report of the joint national committee on prevention, detection, evaluation, and treatment of high blood pressure: the JNC 7 report. JAMA 2003;289(19):2560-2571.
American Diabetes Association. Classification and diagnosis of diabetes. Diabetes Care 2015; 38 Suppl:S8-S16.
Hill NR, Fatoba ST, Oke JL, Hirst JA, O’Callaghan CA, Lasserson DS et al. Global Prevalence of Chronic Kidney Disease–A Systematic Review and Meta-Analysis. PLoS One 2016;11(7):e0158765.
Thomas G, Sehgal AR, Kashyap SR, Srinivas TR, Kirwan JP, Navaneethan SD. Metabolic syndrome and kidney disease: a systematic review and meta-analysis. Clin J Am Soc Nephrol 2011;6(10):2364-2373.
Kim JK, Ju YS, Moon SJ, Song YR, Kim HJ, Kim SG. High pulse pressure and metabolic syndrome are associated with proteinuria in young adult women. BMC Nephrol 2013;14:45.
Hong N, Oh J, Lee YH, Youn JC, Park S, Lee SH et al. Comparison of association of glomerular filtration rate with metabolic syndrome in a community-based population using the CKD-EPI and MDRD study equations. Clin Chim Acta 2014;429:157-162.
Prasad GV. Metabolic syndrome and chronic kidney disease: Current status and future directions. World J Nephrol 2014;3(4):210-19.
Zhang X, Lerman LO. The metabolic syndrome and chronic kidney disease. Transl Res 2017;183:14-25.
Garofalo C, Borrelli S, Pacilio M, Minutolo R, Chiodini P, De Nicola L et al. Hypertension and Prehypertension and Prediction of Development of Decreased Estimated GFR in the General Population: A Meta-analysis of Cohort Studies. Am J Kidney Dis 2016;67(1):89-97.
Altay S, Onat A, Özpamuk-Karadeniz F, Karadeniz Y, Kemalo?lu-Öz T, Can G. Renal "hyperfiltrators" are at elevated risk of death and chronic diseases. BMC Nephrol 2014;15:160.
Onat A, Kaya A, Ademoglu E. Modified risk associations of lipoproteins and apolipoproteins by chronic low-grade inflammation. Expert Rev Cardiovasc Ther 2018;16(1):39-48.
Gluba A, Mikhailidis DP, Lip GY, Hannam S, Rysz J, Banach M. Metabolic syndrome and renal disease. Int J Cardiol 2013;64(2):141-150.
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