Introduction: The pathogenesis of renal disease in obesity and metabolic syndrome (MS) is mostly unknown. This is in part because of the limited information about renal morphological changes in these conditions. We evaluated renal histology in subjects with MS and those without MS, who are participants in the European Nephrectomy Biobank (ENBiBA) project. Methods: MS was defined with at least 3 of the following criteria: (i) body mass index (BMI) ≥27 kg/m2; (ii) prediabetes: fasting glucose of 100–125 mg/dl or HbA1c >5.7%; (iii) systolic or diastolic blood pressure >140/90 mm Hg or the use of medications; and (iv) triglycerides >150 mg/dl or high-density lipoprotein cholesterol <40 (in men) or 50 mg/dl (in women). The absence of these criteria defined patients without MS. Exclusion criteria were diabetes or known causes of renal disease. Results: A total of 157 cases were evaluated: 49 without and 108 with MS. Those with MS were older (54 ± 16 vs. 66 ± 11, P < 0.0001), had more prevalent chronic kidney disease (CKD, estimated glomerular filtration rate [eGFR] <60 ml/min): 24% (23%) versus 4% (8%) (P = 0.02), and had higher albumin-to-creatinine ratio (10 [4–68] vs. 4.45 [0–27], P = 0.05) than those without MS. Global sclerosis (3% [1–7] vs. 7% [3–13], P < 0.0001), nodular sclerosis, mesangial expansion, glomerulomegaly; moderate + severe hyalinosis, and arteriosclerosis were more frequent in those with MS than in those without (88 [82] vs. 29 [59]; 83 [77] vs. 30 [61]; P < 0.05). These vascular changes were independent of differences in age. Conclusion: In MS, ischemic renal disease may play a role in renal disease. In addition, some patients may develop lesions compatible with diabetic nephropathy such as increased mesangial expansion and nodular sclerosis. Further analyses are needed to study the consequences of the pandemic of obesity on renal health.
Renal Disease in Metabolic Syndrome: the Hidden Role of Intrarenal Ischemia / Rodriguez-Rodriguez, R.; Hornum, M.; Rodriguez Rodriguez, A. E.; Bevc, S.; Trevisani, F.; Fernandez, G.; Hojs, R.; Fernandez-Fernandez, B.; Cases Corona, C. M.; Cruzado, J. M.; Quero, M.; Diaz, M. N.; Bettiga, A.; Moreso, F.; Carro, C. G.; Khazim, K.; Ghanem, F.; Ibernon, M.; Laranjinhia, I.; Mendonca, L.; Vieira, M. B.; Feldt-Rasmussen, B.; Ortiz, A.; Bagi, P.; Sorensen, C. A.; Morales, E.; Porrini, E.; Pujol, L.; Montserrat Goma, S. B.; Cruzado, J.; Ibernon, M.; Lopez-Martinez, ; Mads Hornum, M.; Feldt-Rasmussen, ; Alberto Ortiz, B.; Fernandez-Fernandez, B.; Goma-Garces, E.; Stock da Cunha, T.; Sanz, A. B.; Garranzo, M.; Gonzalez-Enguita, C.; Autran-Gomez, ; Pablo Cannata, A. M.; Khazim, K.; Mena, N. N.; Ivo Laranjinhia, T. C.; Miguel Bigotte Vieira, L. M.; Francesco, T.; Di Marco, F.; Salonia, A.; Montorsi, F.; Giacomo, D. A.; Praga, M.. - In: KIDNEY INTERNATIONAL REPORTS. - ISSN 2468-0249. - 9:5(2024), pp. 1419-1428. [10.1016/j.ekir.2024.02.1403]
Renal Disease in Metabolic Syndrome: the Hidden Role of Intrarenal Ischemia
Trevisani F.;Salonia A.;Montorsi F.;
2024-01-01
Abstract
Introduction: The pathogenesis of renal disease in obesity and metabolic syndrome (MS) is mostly unknown. This is in part because of the limited information about renal morphological changes in these conditions. We evaluated renal histology in subjects with MS and those without MS, who are participants in the European Nephrectomy Biobank (ENBiBA) project. Methods: MS was defined with at least 3 of the following criteria: (i) body mass index (BMI) ≥27 kg/m2; (ii) prediabetes: fasting glucose of 100–125 mg/dl or HbA1c >5.7%; (iii) systolic or diastolic blood pressure >140/90 mm Hg or the use of medications; and (iv) triglycerides >150 mg/dl or high-density lipoprotein cholesterol <40 (in men) or 50 mg/dl (in women). The absence of these criteria defined patients without MS. Exclusion criteria were diabetes or known causes of renal disease. Results: A total of 157 cases were evaluated: 49 without and 108 with MS. Those with MS were older (54 ± 16 vs. 66 ± 11, P < 0.0001), had more prevalent chronic kidney disease (CKD, estimated glomerular filtration rate [eGFR] <60 ml/min): 24% (23%) versus 4% (8%) (P = 0.02), and had higher albumin-to-creatinine ratio (10 [4–68] vs. 4.45 [0–27], P = 0.05) than those without MS. Global sclerosis (3% [1–7] vs. 7% [3–13], P < 0.0001), nodular sclerosis, mesangial expansion, glomerulomegaly; moderate + severe hyalinosis, and arteriosclerosis were more frequent in those with MS than in those without (88 [82] vs. 29 [59]; 83 [77] vs. 30 [61]; P < 0.05). These vascular changes were independent of differences in age. Conclusion: In MS, ischemic renal disease may play a role in renal disease. In addition, some patients may develop lesions compatible with diabetic nephropathy such as increased mesangial expansion and nodular sclerosis. Further analyses are needed to study the consequences of the pandemic of obesity on renal health.I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.
