Renal damage in the metabolic syndrome (MetSx): Disorders implicated
The prevalence of metabolic syndrome is increasing worldwide and has become a risk factor for the development of chronic kidney disease. The complex linkage between metabolic syndrome and chronic kidney disease is under research and the factors involved beyond the biological pathogenesis include demographic, sociological and psychological factors that are related to the metabolic syndrome prevalence. The social context of disease causation is as relevant to today's clinical scientist and practitioner as biomarker-directed risk stratification and therapy. The aim of this review is to compare the criteria for diagnosis among different international health organizations, identifying all factors that contribute to the development of this association between metabolic syndrome and chronic kidney disease, and categorizing them by those that could be useful for preventive strategies. In addition, patients with metabolic syndrome have microvascular disease characterized by microalbuminuria, decreased glomerular filtration rate, tubular atrophy, interstitial fibrosis, and glomerulosclerosis. These effects may be due to insulin resistance, hypertension, dyslipidemias, activation of inflammatory processes, fibrotic, dysbiosis and generation of oxidative stress; which cause an imbalance in the main vasoactive factors and thus endothelial dysfunction, deteriorating the renal function. Furthermore, since unhealthy eating habits and a sedentary lifestyle are among the strongest risk factors related to these diseases, lifestyle interventions programs have been recommended for facilitating positive changes in behavior at the individual level. However, further research is needed to promote multiple social, economic and political transformations, shifting the intervention emphasis from individual education, counseling, regimens and medications to community, national and global institutions.