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Physician’s Weekly

Physician’s Weekly

Metabolic Syndrome May Worsen CKD Outcomes

Metabolic Syndrome May Worsen CKD Outcomes

New research suggests that chronic kidney disease patients who also have metabolic syndrome are at higher risk for poor outcomes. Learn the risk factors and what you can do about them.


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Metabolic syndrome is associated with a high risk for cardiovascular events such as heart attack, as well as all-cause mortality (death from any cause) in the general population. Little research has been done, however, on how metabolic syndrome affects chronic kidney disease (CKD) patients with moderate kidney function loss and/or albuminuria, the presence of the protein albumin in your urine. A  study in the Journal of Internal Medicine explored possible associations between metabolic syndrome, all-cause mortality, and cardiovascular outcomes in CKD patients.

What They Did

Scientists from the Medical University of Innsbruck in Austria selected 5,110 participants from the ongoing German Chronic Kidney Disease (GCKD) study. The study aimed to enroll patients with either an estimated glomerular filtration rate (eGFR) 30–60 or an eGFR over 60 but with high levels of protein in their urine, a common sign of kidney disease. Glomerular filtration rate is the percentage of remaining kidney function.  

The research team examined the association between death from all causes, cardiovascular outcomes, and such metabolic syndrome components as:

  • Increased Waist Circumference 
  • High Glucose 
  • Elevated Triglycerides 
  • High Blood Pressure 
  • Low HDLs (“Good” Cholesterol)

What They Found

Nearly 64.3% of the participants had metabolic syndrome at the start of the study. Over the course of the 6.5-year follow-up, patients with metabolic syndrome had a higher risk of both all-cause mortality and cardiovascular events. The greater the number of metabolic syndrome factors, the higher the risk of cardiovascular events and death from any cause. The glucose component of metabolic syndrome led to the highest risk increase for all-cause mortality and cardiovascular events. 

At follow-up, there had been 605 deaths (11.8% of participants). Deaths from cardiovascular issues and deaths from infections had higher relative frequency (how often an event occurs, divided by all outcomes) in participants with metabolic syndrome than in those without it. 

What It Means

The study findings have several potentially beneficial applications. The related increases of metabolic syndrome factors and adverse outcomes are easy to explain to patients, which may motivate patients to work on each relevant factor in order to reduce their risks of cardiovascular events and premature death. The results also indicate that prioritizing the management of glucose factors–including insulin resistance–may be a valid approach to treatment and suggest that drug treatment in combination with lifestyle changes could positively affect other metabolic syndrome factors such as visceral fat and high blood pressure. 

*Physician’s Weekly. (2021, August 10). Metabolic Syndrome May Worsen Outcomes in Chronic Kidney Disease. https://www.physiciansweekly.com/metabolic-syndrome-may-worsen-outcomes-in-chronic-kidney-disease

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