Review Article

Metabolic Syndrome, Chronic Kidney Disease, and Cardiovascular Disease: A Dynamic and Life-Threatening Triad

Table 2

Studies that evaluated the association between the metabolic syndrome and chronic kidney disease.

StudyDesignResults

Chen et al.; Ann Intern Med 2004 [68]Observational, cross-sectional N = 6217 American adults (database: NHANES III)OR for CKD 2.60 (CI: 1.68–4.03)
OR for 2, 3, 4 or 5 traits of MS: 2.21 (CI: 1.16–4.24), 3.38 (C: 1.48–7.69), 4.23 (CI: 2.06–8.63), and 5.85 (CI: 3.11–11.0), respectively.

Kurella et al., J Am Soc Nephrol 2005 [74]Observational, longitudinal (followup 9 yrs) N = 10 096 nondiabetic, American adults (database: ARIC Study)OR for CKD 1.43 (CI: 1.18–1.73)
OR for CKD associated with 1, 2, 3, 4 or 5 traits of MS: 1.13 (CI: 0.89–1.45), 1.53 (CI: 1.18–1.98), 1.75 (CI: 1.32–2.33), 1.84 (95% CI, 1.27–2.67), and 2.45 (CI: 1.32–4.54), respectively.
OR for CKD (excluded pts with DM or HT during followup) 1.24 (CI: 1.01–1.51)

Tanaka et al., Kidney Int 2006 [75]Observational, cross-sectional N = 6980 Japanese adultsOR for CKD 1.54 (CI: 1.28–1.85)
Association only significant for participants younger than 60 y/o.

Rashidi et al., Clin J Am Soc Nephrol 2007 [76]Observational, longitudinal (followup 3 yrs) N = 4 607 non-diabetic (database: TLGS Study)OR for CKD 1.88 (CI: 1.26–2.8)
OR for CKD (excluded pts with HT) 0.92 (CI: 0.446–1.917)

Chen et al., Nephrol Dial Transplant 2007 [77]Observational, cross-sectional N = 15 160 chinese adults (database: inter-Asia study)OR for CKD 1.64 (CI: 1.16–2.732)
OR for CKD associated with 1, 2, 3 and 4 + 5 traits of MS: 1.51 (CI: 1.02–2.23), 1.50 (CI: 0.97–2.32), 2.13 (CI: 1.30–3.50), and 2.72 (CI: 1.50–4.93), respectively.
OR for CKD (excluded pts with HT) 1.74 (CI: 1.00–3.02)
OR for CKD (excluded pts with DM) 1.46 (CI: 1.02–2.07)

Zhang et al., Mayo Clin Proc 2007 [73]Observational, cross-sectional N = 2 310 chinese adultsOR for CKD 1.74 (CI: 1.32–2.30)
OR for CKD (excluded pts with HTor DM) 2.03 (CI: 1.05–3.94)

Kitiyakara et al., Kidney Int 2007 [78]Observational, cross-sectional with a longitudinal subgroup (followup 12 yrs) N = 3 195 Southeastern Asians (subgroup 2067)OR for CKD 2.48 (CI: 1.33–4.62)-cross-sectional
OR for CKD 1.62 (CI: 1.00–2.61)-longitudinal
Association only significant with the NCEP ATP III criteria, not the IDF criteria

Luk et al., Diabetes Care 2008 [79]Observational, longitudinal (Mean followup 4.6 yrs) N = 5 829 diabetic type II pts (database: Hong Kong Diabetes Registry)OR for CKD 1.31 (CI: 1.12–1.54)
OR for CKD associated with 2, 3, 4 or 5 traits of MS: 1.15 (0.83–1.60), 1.32 (0.94–1.86), 1.64 (1.17–2.32), and 2.34 (1.54 –3.54), respectively.

Jang et al., J Public Health 2010 [80]Observational, cross-sectional N = 5136 Korean adults (Database: KNHANES III)OR for CKD 1.77 (P <  .05)

Yu et al., Nephrol Dial Transplant 2010 [81]Observational, cross-sectional N = 5911 Korean adults (Database: KNHANES III)OR for CKD: NS
Association only significant in men younger than 60 y/o and postmenopausal women.

ARIC: Atherosclerosis Risk in Communities; CI: Confidence Interval; CKD: Chronic Kidney Disease; DM: Diabetes Mellitus; HT: Hypertension; IDF: International Diabetes Federation; KNHANES: Korean National Health and Nutrition Examination Survey; MS: Metabolic Syndrome; NCEP ATP: National Cholesterol Education Program Adult Treatment Panel; NHANES: National Health and Nutrition Examination Survey; NS: no significance; OR: Odds Ratio; TLGS: Tehran Lipid and Glucose Study.