Home |
Current Issue |
Past Issues |
In the Clinic |
ACP Journal Club |
CME |
Collections |
Audio/Video |
Mobile |
Subscribe |
Tools |
Help |
ACP Online
|
| ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
3 February 2004 | Volume 140 Issue 3 | Pages 167-174
Background: The metabolic syndrome is a common risk factor for cardiovascular disease.
Objective: To examine the association between the metabolic syndrome and risk for chronic kidney disease and microalbuminuria.
Design: Cross-sectional study.
Setting: The Third National Health and Nutrition Examination Survey.
Patients: Participants 20 years of age or older were studied in the chronic kidney disease (n = 6217) and microalbuminuria (n = 6125) analyses.
Measurements: The metabolic syndrome was defined as the presence of 3 or more of the following risk factors: elevated blood pressure, low high-density lipoprotein cholesterol level, high triglyceride level, elevated glucose level, and abdominal obesity. Chronic kidney disease was defined as a glomerular filtration rate less than 60 mL/min per 1.73 m2, and microalbuminuria was defined as a urinary albumincreatinine ratio of 30 to 300 mg/g.
Results: The multivariate-adjusted odds ratios of chronic kidney disease and microalbuminuria in participants with the metabolic syndrome compared with participants without the metabolic syndrome were 2.60 (95% CI, 1.68 to 4.03) and 1.89 (CI, 1.34 to 2.67), respectively. Compared with participants with 0 or 1 component of the metabolic syndrome, participants with 2, 3, 4, and 5 components of chronic kidney disease had multivariate-adjusted odds ratios of 2.21 (CI, 1.16 to 4.24), 3.38 (CI, 1.48 to 7.69), 4.23 (CI, 2.06 to 8.63), and 5.85 (CI, 3.11 to 11.0), respectively. The corresponding multivariate-adjusted odds ratios of microalbuminuria for participants with 3, 4, and 5 components were 1.62 (CI, 1.10 to 2.38), 2.45 (CI, 1.55 to 3.85), and 3.19 (CI, 1.96 to 5.19), respectively.
Conclusions: These findings suggest that the metabolic syndrome might be an important factor in the cause of chronic kidney disease.
Editors' Notes
Context
Contribution
Cautions
The Editors
Author and Article Information
From Tulane University Schools of Medicine and Public Health and Tropical Medicine, New Orleans, Louisiana, and University of Mississippi School of Medicine, Jackson, Mississippi.
Grant Support: In part by grant U01 DK60963 from the National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Bethesda, Maryland. Dr. Chen is supported by a Building Interdisciplinary Research Careers in Women's Health Scholarship (K12 HD43451) from the National Institutes of Health, Bethesda, Maryland.
Potential Financial Conflicts of Interest: None disclosed.
Requests for Single Reprints: Jiang He, MD, PhD, Department of Epidemiology, Tulane University School of Public Health and Tropical Medicine, 1430 Tulane Avenue SL18, New Orleans, LA 70112; e-mail, jhe{at}tulane.edu.
Current Author Addresses: Drs. Chen, Muntner, Hamm, Batuman, Fonseca, and Whelton: Tulane University, 1430 Tulane Avenue, New Orleans, LA 70112.
Dr. Jones: University of Mississippi, 2500 North State Street, Jackson, MS 39216.
Dr. He: Department of Epidemiology, Tulane University School of Public Health and Tropical Medicine, 1430 Tulane Avenue SL18, New Orleans, LA 70112.
Author Contributions: Conception and design: J. Chen, J. He.
Analysis and interpretation of the data: J. Chen, P. Muntner, J. He.
Drafting of the article: J. Chen, J. He.
Critical revision of the article for important intellectual content: J. Chen, P. Muntner, L.L. Hamm, D.W. Jones, V. Batuman, V. Fonseca, P.K. Whelton, J. He.
Final approval of the article: J. Chen, P. Muntner, L.L. Hamm, D.W. Jones, V. Batuman, V. Fonseca, P.K. Whelton, J. He.
Statistical expertise: J. Chen, P. Muntner, J. He.
Obtaining of funding: J. He.
Administrative, technical, or logistic support: J. He. ARTICLE
The Metabolic Syndrome and Chronic Kidney Disease in U.S. Adults
![]()
![]()
Related articles in Annals:
This article has been cited by other articles:
![]() |
A. Shankar, C. Leng, K. S. Chia, D. Koh, E. S. Tai, S. M. Saw, S. C. Lim, and T. Y. Wong Association between body mass index and chronic kidney disease in men and women: population-based study of Malay adults in Singapore Nephrol. Dial. Transplant., June 1, 2008; 23(6): 1910 - 1918. [Abstract] [Full Text] [PDF] |
||||
![]() |
A. Mima, H. Arai, T. Matsubara, H. Abe, K. Nagai, Y. Tamura, K. Torikoshi, M. Araki, H. Kanamori, T. Takahashi, et al. Urinary Smad1 Is a Novel Marker to Predict Later Onset of Mesangial Matrix Expansion in Diabetic Nephropathy Diabetes, June 1, 2008; 57(6): 1712 - 1722. [Abstract] [Full Text] [PDF] |
||||
![]() |
C. Lorenzo, S. D. Nath, A. J.G. Hanley, H. E. Abboud, and S. M. Haffner Relation of Low Glomerular Filtration Rate to Metabolic Disorders in Individuals without Diabetes and with Normoalbuminuria Clin. J. Am. Soc. Nephrol., May 1, 2008; 3(3): 783 - 789. [Abstract] [Full Text] [PDF] |
||||
![]() |
L. G. Sanchez-Lozada, E. Tapia, P. Bautista-Garcia, V. Soto, C. Avila-Casado, I. P. Vega-Campos, T. Nakagawa, L. Zhao, M. Franco, and R. J. Johnson Effects of febuxostat on metabolic and renal alterations in rats with fructose-induced metabolic syndrome Am J Physiol Renal Physiol, April 1, 2008; 294(4): F710 - F718. [Abstract] [Full Text] [PDF] |
||||
![]() |
K. A. Griffin, H. Kramer, and A. K. Bidani Adverse renal consequences of obesity Am J Physiol Renal Physiol, April 1, 2008; 294(4): F685 - F696. [Abstract] [Full Text] [PDF] |
||||
![]() |
L. L. Yanes, J. C. Sartori-Valinotti, and J. F. Reckelhoff Sex Steroids and Renal Disease: Lessons From Animal Studies Hypertension, April 1, 2008; 51(4): 976 - 981. [Full Text] [PDF] |
||||
![]() |
R. D. Bloom and M. F. Crutchlow New-Onset Diabetes Mellitus in the Kidney Recipient: Diagnosis and Management Strategies Clin. J. Am. Soc. Nephrol., March 1, 2008; 3(Supplement_2): S38 - S48. [Abstract] [Full Text] [PDF] |
||||
![]() |
E. Pimenta, K. K. Gaddam, M. N. Pratt-Ubunama, M. K. Nishizaka, I. Aban, S. Oparil, and D. A. Calhoun Relation of Dietary Salt and Aldosterone to Urinary Protein Excretion in Subjects With Resistant Hypertension Hypertension, February 1, 2008; 51(2): 339 - 344. [Abstract] [Full Text] [PDF] |
||||
![]() |
S. Basi, P. Fesler, A. Mimran, and J. B. Lewis Microalbuminuria in Type 2 Diabetes and Hypertension: A marker, treatment target, or innocent bystander? Diabetes Care, February 1, 2008; 31(Supplement_2): S194 - S201. [Full Text] [PDF] |
||||
![]() |
I. H. de Boer, B. C. Astor, H. Kramer, W. Palmas, S. L. Seliger, M. G. Shlipak, D. S. Siscovick, M. Y. Tsai, and B. Kestenbaum Lipoprotein Abnormalities Associated with Mild Impairment of Kidney Function in the Multi-Ethnic Study of Atherosclerosis Clin. J. Am. Soc. Nephrol., January 1, 2008; 3(1): 125 - 132. [Abstract] [Full Text] [PDF] |
||||
![]() |
T. Fujita Insulin resistance and salt-sensitive hypertension in metabolic syndrome Nephrol. Dial. Transplant., November 1, 2007; 22(11): 3102 - 3107. [Full Text] [PDF] |
||||
![]() |
A. Whaley-Connell, B. S. Pavey, K. Chaudhary, G. Saab, and J. R. Sowers Review: Renin-angiotensin-aldosterone system intervention in the cardiometabolic syndrome and cardio-renal protection Therapeutic Advances in Cardiovascular Disease, October 1, 2007; 1(1): 27 - 35. [Abstract] [PDF] |
||||
![]() |
P. Korantzopoulos, M. Elisaf, and H. J. Milionis Multifactorial intervention in metabolic syndrome targeting at prevention of chronic kidney disease ready for prime time? Nephrol. Dial. Transplant., October 1, 2007; 22(10): 2768 - 2774. [Full Text] [PDF] |
||||
![]() |
S. Kume, T. Uzu, S.-i. Araki, T. Sugimoto, K. Isshiki, M. Chin-Kanasaki, M. Sakaguchi, N. Kubota, Y. Terauchi, T. Kadowaki, et al. Role of Altered Renal Lipid Metabolism in the Development of Renal Injury Induced by a High-Fat Diet J. Am. Soc. Nephrol., October 1, 2007; 18(10): 2715 - 2723. [Abstract] [Full Text] [PDF] |
||||
![]() |
M. S. Gersch, W. Mu, P. Cirillo, S. Reungjui, L. Zhang, C. Roncal, Y. Y. Sautin, R. J. Johnson, and T. Nakagawa Fructose, but not dextrose, accelerates the progression of chronic kidney disease Am J Physiol Renal Physiol, October 1, 2007; 293(4): F1256 - F1261. [Abstract] [Full Text] [PDF] |
||||
![]() |
A. A. Ellington, A. R. Malik, G. G. Klee, S. T. Turner, A. D. Rule, T. H. Mosley Jr, and I. J. Kullo Association of Plasma Resistin With Glomerular Filtration Rate and Albuminuria in Hypertensive Adults Hypertension, October 1, 2007; 50(4): 708 - 714. [Abstract] [Full Text] [PDF] |
||||
![]() |
M. Franciosi, F. Pellegrini, M. Sacco, G. De Berardis, M. C.E. Rossi, G. F.M. Strippoli, M. Belfiglio, G. Tognoni, M. Valentini, A. Nicolucci, et al. Identifying Patients at Risk for Microalbuminuria via Interaction of the Components of the Metabolic Syndrome: A Cross-Sectional Analytic Study Clin. J. Am. Soc. Nephrol., September 1, 2007; 2(5): 984 - 991. [Abstract] [Full Text] [PDF] |
||||
![]() |
A. Rashidi, A. Ghanbarian, and F. Azizi Are Patients Who Have Metabolic Syndrome without Diabetes at Risk for Developing Chronic Kidney Disease? Evidence Based on Data from a Large Cohort Screening Population Clin. J. Am. Soc. Nephrol., September 1, 2007; 2(5): 976 - 983. [Abstract] [Full Text] [PDF] |
||||
![]() |
N. M. Maalouf, M. A. Cameron, O. W. Moe, B. Adams-Huet, and K. Sakhaee Low Urine pH: A Novel Feature of the Metabolic Syndrome Clin. J. Am. Soc. Nephrol., September 1, 2007; 2(5): 883 - 888. [Abstract] [Full Text] [PDF] |
||||
![]() |
E. Ritz Metabolic Syndrome: An Emerging Threat to Renal Function Clin. J. Am. Soc. Nephrol., September 1, 2007; 2(5): 869 - 871. [Full Text] [PDF] |
||||
![]() |
J. Dominguez, P. Wu, C. S. Packer, C. Temm, and K. J. Kelly Lipotoxic and inflammatory phenotypes in rats with uncontrolled metabolic syndrome and nephropathy Am J Physiol Renal Physiol, September 1, 2007; 293(3): F670 - F679. [Abstract] [Full Text] [PDF] |
||||
![]() |
M. F. Crutchlow, B. Robinson, B. Pappachen, N. Wimmer, A. J. Cucchiara, D. Cohen, and R. Townsend Validation of Steady-State Insulin Sensitivity Indices in Chronic Kidney Disease Diabetes Care, July 1, 2007; 30(7): 1813 - 1818. [Abstract] [Full Text] [PDF] |
||||
![]() |
P. K. Chandie Shaw, S. P. Berger, M. Mallat, M. Frolich, F. W. Dekker, and T. J. Rabelink Central Obesity Is an Independent Risk Factor for Albuminuria in Nondiabetic South Asian Subjects Diabetes Care, July 1, 2007; 30(7): 1840 - 1844. [Abstract] [Full Text] [PDF] |
||||
![]() |
M. Postorino, C. Marino, G. Tripepi, C. Zoccali, and on behalf of the Calabrian Registry of Dialysis an Prognostic value of the New York Heart Association classification in end-stage renal disease Nephrol. Dial. Transplant., May 1, 2007; 22(5): 1377 - 1382. [Abstract] [Full Text] [PDF] |
||||
![]() |
I. M. Wahba and R. H. Mak Obesity and Obesity-Initiated Metabolic Syndrome: Mechanistic Links to Chronic Kidney Disease Clin. J. Am. Soc. Nephrol., May 1, 2007; 2(3): 550 - 562. [Abstract] [Full Text] [PDF] |
||||
![]() |
G. Pambianco, T. Costacou, and T. J. Orchard The Prediction of Major Outcomes of Type 1 Diabetes: a 12-Year Prospective Evaluation of Three Separate Definitions of the Metabolic Syndrome and Their Components and Estimated Glucose Disposal Rate: The Pittsburgh Epidemiology of Diabetes Complications Study experience Diabetes Care, May 1, 2007; 30(5): 1248 - 1254. [Abstract] [Full Text] [PDF] |
||||
![]() |
J. Chen, D. Gu, C.-S. Chen, X. Wu, L. L. Hamm, P. Muntner, V. Batuman, C.-H. Lee, P. K. Whelton, and J. He Association between the metabolic syndrome and chronic kidney disease in Chinese adults Nephrol. Dial. Transplant., April 1, 2007; 22(4): 1100 - 1106. [Abstract] [Full Text] [PDF] |
||||
![]() |
W. McClellan, R. Speckman, L. McClure, V. Howard, R. C. Campbell, M. Cushman, P. Audhya, G. Howard, and D. G. Warnock Prevalence and Characteristics of a Family History of End-Stage Renal Disease among Adults in the United States Population: Reasons for Geographic and Racial Differences in Stroke (REGARDS) Renal Cohort Study J. Am. Soc. Nephrol., April 1, 2007; 18(4): 1344 - 1352. [Abstract] [Full Text] [PDF] |
||||
![]() |
M. F. Crutchlow and R. D. Bloom Transplant-Associated Hyperglycemia: A New Look at an Old Problem Clin. J. Am. Soc. Nephrol., March 1, 2007; 2(2): 343 - 355. [Abstract] [Full Text] [PDF] |
||||
![]() |
T. S. Perlstein, M. Gerhard-Herman, N. K. Hollenberg, G. H. Williams, and A. Thomas Insulin Induces Renal Vasodilation, Increases Plasma Renin Activity, and Sensitizes the Renal Vasculature to Angiotensin Receptor Blockade in Healthy Subjects J. Am. Soc. Nephrol., March 1, 2007; 18(3): 944 - 951. [Abstract] [Full Text] [PDF] |
||||
![]() |
C. Berry, J.-C. Tardif, and M. G. Bourassa Coronary Heart Disease in Patients With Diabetes: Part I: Recent Advances in Prevention and Noninvasive Management J. Am. Coll. Cardiol., February 13, 2007; 49(6): 631 - 642. [Abstract] [Full Text] [PDF] |
||||
![]() |
V. G. Athyros, D. P. Mikhailidis, E. N. Liberopoulos, A. I. Kakafika, A. Karagiannis, A. A. Papageorgiou, K. Tziomalos, E. S. Ganotakis, and M. Elisaf Effect of statin treatment on renal function and serum uric acid levels and their relation to vascular events in patients with coronary heart disease and metabolic syndrome: A subgroup analysis of the GREek Atorvastatin and Coronary heart disease Evaluation (GREACE) Study Nephrol. Dial. Transplant., January 1, 2007; 22(1): 118 - 127. [Abstract] [Full Text] [PDF] |
||||
![]() |
S. Ryu, Y. Chang, D.-I. Kim, W. S. Kim, and B.-S. Suh {gamma}-Glutamyltransferase as a Predictor of Chronic Kidney Disease in Nonhypertensive and Nondiabetic Korean Men Clin. Chem., January 1, 2007; 53(1): 71 - 77. [Abstract] [Full Text] [PDF] |
||||
![]() |
I. H. de Boer, S. D. Sibley, B. Kestenbaum, J. N. Sampson, B. Young, P. A. Cleary, M. W. Steffes, N. S. Weiss, J. D. Brunzell, and for the Diabetes Control and Complications Trial/E Central Obesity, Incident Microalbuminuria, and Change in Creatinine Clearance in the Epidemiology of Diabetes Interventions and Complications Study J. Am. Soc. Nephrol., January 1, 2007; 18(1): 235 - 243. [Abstract] [Full Text] [PDF] |
||||
![]() |
S. Mathew, R. J. Lund, F. Strebeck, K. S. Tustison, T. Geurs, and K. A. Hruska Reversal of the Adynamic Bone Disorder and Decreased Vascular Calcification in Chronic Kidney Disease by Sevelamer Carbonate Therapy J. Am. Soc. Nephrol., January 1, 2007; 18(1): 122 - 130. [Abstract] [Full Text] [PDF] |
||||
![]() |
L. G. Sanchez-Lozada, E. Tapia, A. Jimenez, P. Bautista, M. Cristobal, T. Nepomuceno, V. Soto, C. Avila-Casado, T. Nakagawa, R. J. Johnson, et al. Fructose-induced metabolic syndrome is associated with glomerular hypertension and renal microvascular damage in rats Am J Physiol Renal Physiol, January 1, 2007; 292(1): F423 - F429. [Abstract] [Full Text] [PDF] |
||||
![]() |
G. Mancia, M. Bombelli, G. Corrao, R. Facchetti, F. Madotto, C. Giannattasio, F. Q. Trevano, G. Grassi, A. Zanchetti, and R. Sega Metabolic Syndrome in the Pressioni Arteriose Monitorate E Loro Associazioni (PAMELA) Study: Daily Life Blood Pressure, Cardiac Damage, and Prognosis Hypertension, January 1, 2007; 49(1): 40 - 47. [Abstract] [Full Text] [PDF] |
||||
![]() |
M. Nagase, S. Yoshida, S. Shibata, T. Nagase, T. Gotoda, K. Ando, and T. Fujita Enhanced Aldosterone Signaling in the Early Nephropathy of Rats with Metabolic Syndrome: Possible Contribution of Fat-Derived Factors J. Am. Soc. Nephrol., December 1, 2006; 17(12): 3438 - 3446. [Abstract] [Full Text] [PDF] |
||||
![]() |
P. Cirillo, W. Sato, S. Reungjui, M. Heinig, M. Gersch, Y. Sautin, T. Nakagawa, and R. J. Johnson Uric Acid, the Metabolic Syndrome, and Renal Disease J. Am. Soc. Nephrol., December 1, 2006; 17(12_suppl_3): S165 - S168. [Abstract] [Full Text] [PDF] |
||||
![]() |
S. G. de Vinuesa, M. Goicoechea, J. Kanter, M. Puerta, V. Cachofeiro, V. Lahera, F. Gomez-Campdera, and J. Luno Insulin Resistance, Inflammatory Biomarkers, and Adipokines in Patients with Chronic Kidney Disease: Effects of Angiotensin II Blockade J. Am. Soc. Nephrol., December 1, 2006; 17(12_suppl_3): S206 - S212. [Abstract] [Full Text] [PDF] |
||||
![]() |
J. Redon, F. Morales-Olivas, A. Galgo, M. A. Brito, J. Mediavilla, R. Marin, P. Rodriguez, S. Tranche, J. V. Lozano, C. Filozof, et al. Urinary Albumin Excretion and Glomerular Filtration Rate across the Spectrum of Glucose Abnormalities in Essential Hypertension J. Am. Soc. Nephrol., December 1, 2006; 17(12_suppl_3): S236 - S245. [Abstract] [Full Text] [PDF] |
||||
![]() |
C. Tomiyama, A. Higa, M. A. Dalboni, M. Cendoroglo, S. A. Draibe, L. Cuppari, A. B. Carvalho, E. M. Neto, and M. E. F. Canziani The impact of traditional and non-traditional risk factors on coronary calcification in pre-dialysis patients Nephrol. Dial. Transplant., September 1, 2006; 21(9): 2464 - 2471. [Abstract] [Full Text] [PDF] |
||||
![]() |
P. E. de Jong and G. C. Curhan Screening, Monitoring, and Treatment of Albuminuria: Public Health Perspectives J. Am. Soc. Nephrol., August 1, 2006; 17(8): 2120 - 2126. [Abstract] [Full Text] [PDF] |
||||
![]() |
K. Amann, C. Wanner, and E. Ritz Cross-Talk between the Kidney and the Cardiovascular System J. Am. Soc. Nephrol., August 1, 2006; 17(8): 2112 - 2119. [Abstract] [Full Text] [PDF] |
||||
![]() |
G. M. Chertow, C.-y. Hsu, and K. L. Johansen The Enlarging Body of Evidence: Obesity and Chronic Kidney Disease J. Am. Soc. Nephrol., June 1, 2006; 17(6): 1501 - 1502. [Full Text] [PDF] |
||||
![]() |
M. B. Davidson, J. K. Hix, D. G. Vidt, and D. J. Brotman Association of Impaired Diurnal Blood Pressure Variation With a Subsequent Decline in Glomerular Filtration Rate. Arch Intern Med, April 24, 2006; 166(8): 846 - 852. [Abstract] [Full Text] [PDF] |
||||
![]() |
K. Iseki Screening for renal disease--what can be learned from the Okinawa experience Nephrol. Dial. Transplant., April 1, 2006; 21(4): 839 - 843. [Full Text] [PDF] |
||||
![]() |
R. Yamamoto and Y. Aso Synergistic Association of Metabolic Syndrome and Overt Nephropathy With Elevated Asymmetric Dimethylarginine in Serum and Impaired Cutaneous Microvasodilation in Patients With Type 2 Diabetes Diabetes Care, April 1, 2006; 29(4): 928 - 930. [Full Text] [PDF] |
||||
![]() |
F. Locatelli, P. Pozzoni, and L. Del Vecchio Renal Manifestations in the Metabolic Syndrome. J. Am. Soc. Nephrol., April 1, 2006; 17(4_suppl_2): S81 - S85. [Abstract] [Full Text] [PDF] |
||||
![]() |
E. Ratto, G. Leoncini, F. Viazzi, V. Vaccaro, A. Parodi, V. Falqui, N. Conti, C. Tomolillo, G. Deferrari, and R. Pontremoli Metabolic Syndrome and Cardiovascular Risk in Primary Hypertension. J. Am. Soc. Nephrol., April 1, 2006; 17(4_suppl_2): S120 - S122. [Abstract] [Full Text] [PDF] |
||||
![]() |
R. Trevisan, A. R. Dodesini, and G. Lepore Lipids and Renal Disease J. Am. Soc. Nephrol., April 1, 2006; 17(4_suppl_2): S145 - S147. [Abstract] [Full Text] [PDF] |
||||
![]() |
T. A. McGowan, S. R. Dunn, B. Falkner, and K. Sharma Stimulation of Urinary TGF-{beta} and Isoprostanes in Response to Hyperglycemia in Humans Clin. J. Am. Soc. Nephrol., March 1, 2006; 1(2): 263 - 268. [Abstract] [Full Text] [PDF] |
||||
![]() |
P. L. Kimmel Update in nephrology and hypertension. Ann Intern Med, February 21, 2006; 144(4): 281 - 285. [Full Text] [PDF] |
||||
![]() |
S. De Cosmo, R. Trevisan, A. Minenna, M. Vedovato, R. Viti, S. A. Santini, A. R. Dodesini, P. Fioretto, and V. Trischitta Insulin Resistance and the Cluster of Abnormalities Related to the Metabolic Syndrome Are Associated With Reduced Glomerular Filtration Rate in Patients With Type 2 Diabetes Diabetes Care, February 1, 2006; 29(2): 432 - 434. [Full Text] [PDF] |
||||
![]() |
M. Pladevall, B. Singal, L. K. Williams, C. Brotons, H. Guyer, J. Sadurni, C. Falces, M. Serrano-Rios, R. Gab |