Both metabolic syndrome (MetS) and chronic kidney disease (CKD) are major global health issues. Current clinical markers used to reflect renal injury include albuminuria and estimated glomerular filtration rate (eGFR). Given the same eGFR level, urine albumin might be a better risk marker to predict progression of CKD and future development of cardiovascular diseases (CVDs). Serum Cystatin C is emerging as a new biomarker for early detection of renal injury associated with MetS and cardiovascular risk. In addition to each component, MetS per se influences the incidence and prognosis of renal injury and the odds ratios increased with the increase in the number of metabolic abnormalities. Hyperinsulinemia, activation of rennin-angiotensin-aldosterone system, increase of oxidative stress, and inflammatory cytokines are proposed to be the plausible biological link between MetS and CKD. Weight control, stick control of blood pressure, glucose, and lipids disorders may lead to lessening renal injury and even the subsequent CVD. 1. Introduction MetS, a complicated clinicopathological entity with clustering of CVD and metabolic risk factors, includes central obesity, hypertension, dyslipidemia, and glucose intolerance. It has been pervasively recognized that individuals with MetS are associated with the increased risks of type 2 diabetes and CVD [1–3]. Abdominal fat plays an important role in MetS, because it is predictive of sensitivity to insulin [4, 5]. It has been reported that obesity adversely affects renal function and may be associated with morbidity and mortality in patients with CKD [4]. Recent evidence also indicated that presence of MetS is associated with an increased risk of developing CKD [6, 7]. As a matter of fact, both MetS and CKD are major global health issues with regard to the increasing prevalence of obesity and aging society [8–11]. What is more alarming is the fact that the prevalence of end-stage renal disease has more than doubled in the recent ten years [9]. Although the relationship between MetS and CKD was established, the detailed understanding of quantitative association between MetS and its components implicated in kidney damage is still limited. In this paper, we will review the following issues: (1)epidemiological association between MetS and CKD incidence and/or progression, (2)reliable markers of MetS associated with renal injury,(3)plausible biologic links between MetS and CKD,(4)impact of treating the MetS on the risk of renal injury or CKD progress. 2. Epidemiological Association between MetS and CKD Incidence and/or
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