Metabolic syndrome is a predictor of decreased renal function among community-dwelling middle-aged and elderly Japanese

Chronic kidney disease combined with metabolic syndrome is a non-negligible risk factor

Metabolic syndrome (MetS) is a group of conditions characterized by hypertension (HTN), hyperglycaemia or insulin resistance (IR), hyperlipidaemia, and abdominal obesity. MetS is associated with a high incidence of cardiovascular events and mortality and is an independent risk factor for chronic kidney disease (CKD). MetS can cause CKD or accelerate the progression of kidney disease. Recent studies have found that MetS and kidney disease have a cause-and-effect relationship. Patients with CKD, those undergoing kidney transplantation, or kidney donors have a significantly higher risk of developing MetS than normal people. The present study reviewed the possible mechanisms of MetS in patients with CKD, including the disorders of glucose and fat metabolism after kidney injury, IR, HTN and the administration of glucocorticoid and calcineurin inhibitors. In addition, this study reviewed the effect of MetS in patients with CKD on important target organs such as the kidney, heart, brain and blood vessels, and the treatment and prevention of CKD combined with MetS. The study aims to provide strategies for the diagnosis, treatment and prevention of CKD in patients with MetS.

Metabolic syndrome as a risk factor for the development of kidney dysfunction: a meta-analysis of observational cohort studies

Background

Chronic kidney disease (CKD) is a major global health concern with increasing prevalence and associated complications. Metabolic syndrome (MetS) has been linked to CKD, but the evidence remains inconsistent. We conducted a systematic review and meta-analysis to investigate the association between MetS and kidney dysfunction.

Method

We conducted a comprehensive search of databases until December 2022 for cohort studies assessing the association between MetS and incident kidney dysfunction. Meta-analysis was performed using fixed and random effects models. Subgroup analyses were conducted to explore heterogeneity. Publication bias was assessed using Egger's and Begg's tests.

Result

A total of 24 eligible studies, involving 6,573,911 participants, were included in this meta-analysis. MetS was significantly associated with an increased risk of developing CKD (OR, 1.42; 95% CI, 1.28, 1.57), albuminuria or proteinuria (OR, 1.43; 95% CI, 1.10, 1.86), and rapid decline in kidney function (OR, 1.25; 95% CI, 1.07, 1.47). Subgroup analyses showed a stronger association as the number of MetS components increased. However, gender-specific subgroups demonstrated varying associations.

Conclusion

Metabolic syndrome is a significant risk factor for kidney dysfunction, requiring close renal monitoring. Lifestyle changes and targeted interventions may help reduce CKD burden. Further research is needed to understand the connection fully and assess intervention efficacy.

Supplementary Information

The online version contains supplementary material available at 10.1007/s40200-023-01348-5.

Effects of Metabolic Syndrome and Its Components on Chronic Kidney Disease and Renal Function: A Two-Sample Mendelian Randomization Study

Objective: The association of metabolic syndrome (MetS) and its components with chronic kidney disease (CKD) and renal function remains controversial in observational studies. To comprehensively investigate the association between MetS and its components with CKD and renal function, a Mendelian randomization (MR) study was performed. Methods: The inverse variance weighting (IVW) of random effects was used as the main estimation method, while MR-Egger and weighted median analysis results were used for auxiliary judgments. Cochran's Q test, MR-Egger intercept test, leave-one-out analysis, and funnel plots were used to assess heterogeneity and pleiotropy. Results: The MR analyses of genetically predicted MetS and its components' association with CKD risk and renal function showed the following causal associations: hypertension with CKD risk; MetS and obesity with increased blood urea nitrogen and decreased estimated glomerular filtration rate based on cystatin C; hypertension and diabetes with increased urine albumin-creatinine ratio and increased risk of microalbuminuria; and CKD with increased triglyceride. Conclusion: Based on genetic data, this study demonstrated an association between hypertension and CKD risk and a causal association between other MetS components and renal function. The early diagnosis and prevention of MetS and its components might be essential for CKD management.

Antioxidant and anti-inflammatory effects of allicin in the kidney of an experimental model of metabolic syndrome

Background

Recent studies have suggested that metabolic syndrome (MS) encompasses a group of risk factors for developing chronic kidney disease (CKD). This work aimed to evaluate the antioxidant and anti-inflammatory effects of allicin in the kidney from an experimental model of MS.

Methods

Male Wistar rats (220-250 g) were used, and three experimental groups (n = 6) were formed: control (C), metabolic syndrome (MS), and MS treated with allicin (16 mg/Kg/day, gastric gavage) (MS+A). MS was considered when an increase of 20% in at least three parameters (body weight, systolic blood pressure (SBP), fasting blood glucose (FBG), or dyslipidemia) was observed compared to the C group. After the MS diagnosis, allicin was administered for 30 days.

Results

Before the treatment with allicin, the MS group showed more significant body weight gain, increased SBP, and FBG, glucose intolerance, and dyslipidemia. In addition, increased markers of kidney damage in urine and blood. Moreover, the MS increased oxidative stress and inflammation in the kidney compared to group C. The allicin treatment prevented further weight gain, reduced SBP, FBG, glucose intolerance, and dyslipidemia. Also, markers of kidney damage in urine and blood were decreased. Further, the oxidative stress and inflammation were decreased in the renal cortex of the MS+A compared to the MS group.

Conclusion

Allicin exerts its beneficial effects on the metabolic syndrome by considerably reducing systemic and renal inflammation as well as the oxidative stress. These effects were mediated through the Nrf2 pathway. The results suggest allicin may be a therapeutic alternative for treating kidney injury induced by the metabolic syndrome risk factors.

The Triglyceride-Glucose Index is Independently Associated with Chronic Kidney Disease in the Geriatric Population, Regardless of Obesity and Sex

BACKGROUND

Insulin resistance (IR) negatively affects several risk factors of chronic kidney disease (CKD). This cross-sectional study investigated whether the triglyceride-glucose (TyG) index, which reflects IR, was independently associated with CKD in a geriatric population, regardless of obesity and sex.

METHODS

The analysis included 7,326 individuals (2,864 males and 4,462 females) aged ≥60 years. Non-obesity or obesity was evaluated using a body mass index cutoff of 25 kg/m2. The TyG index was calculated as ln [triglyceride concentration (mg/dL)×fasting plasma glucose concentration (mg/dL)]/2. All participants were categorized into three groups according to TyG tertiles. Moderate-to-severe CKD (MSCKD) was defined as an estimated glomerular filtration rate (eGFR) of <45.0 mL/min/1.73 m2.

RESULTS

In males and females with or without obesity, a trend test showed a decreasing tendency in the eGFR from the lowest to highest TyG tertiles. Males without obesity and females with obesity in the middle and highest tertiles of the TyG index were 2.342 and 2.393, and were 2.313 and 3.516 times more likely to have MSCKD, respectively. Those with or without obesity in the highest tertile of the TyG index were 1.736 and 2.374 times more likely to have MSCKD, respectively.

CONCLUSION

Geriatric populations with an increased TyG index have a high risk of MSCKD regardless of obesity and sex. Our findings suggest that increased IR is associated with CKD in the geriatric population independent of obesity and sex.

The Effect of Metabolic Syndrome and Its Individual Components on Renal Function: A Meta-Analysis

BACKGROUND

Observational studies have reported inconsistent findings in the relationship between metabolic syndrome (MetS), its components, and loss of renal function, mainly including eGFR decline, new-onset CKD, and ESRD. This meta-analysis was performed to investigate their potential associations.

METHODS

PubMed and EMBASE were systematically searched from their inception to 21 July 2022. Observational cohort studies in English assessing the risk of renal dysfunction in individuals with MetS were identified. Risk estimates and their 95% confidence intervals (CIs) were extracted and pooled using the random-effects approach.

RESULTS

A total of 32 studies with 413,621 participants were included in the meta-analysis. MetS contributed to higher risks of renal dysfunction (RR = 1.50, 95% CI = 1.39-1.61) and, specifically, rapid decline in eGFR (RR 1.31, 95% CI 1.13-1.51), new-onset CKD (RR 1.47, 95% CI 1.37-1.58), as well as ESRD (RR 1.55, 95% CI 1.08-2.22). Moreover, all individual components of MetS were significantly associated with renal dysfunction, while elevated BP conveyed the highest risk (RR = 1.37, 95% CI = 1.29-1.46), impaired fasting glucose with the lowest and diabetic-dependent risk (RR = 1.20, 95% CI = 1.09-1.33).

CONCLUSIONS

Individuals with MetS and its components are at higher risk of renal dysfunction.

Association between recovery/occurrence of metabolic syndrome and rapid estimated glomerular filtration rate decline in middle-aged and older populations: evidence from the China Health and Retirement Longitudinal Study

OBJECTIVES

Few studies have explored correlations between metabolic syndrome (MetS) alterations and renal deterioration in longitudinal cohorts. We aim to investigate associations between MetS recovery/development and rapid estimated glomerular filtration rate (eGFR) decline in the China Health and Retirement Longitudinal Study (CHARLS).

DESIGN

Longitudinal cohort study.

SETTING

This study is a secondary analysis of CHARLS.

PARTICIPANTS

After excluding individuals with age <45 years old, eGFR <60 mL/min/1.73 m² and clinician-reported malignant tumour, heart disease, stroke or kidney disease at baseline, 4142 participants with complete data were selected from the CHARLS during the 4-year follow-up period (2011-2015).

OUTCOME MEASURES

MetS were measured at 2011 and 2015 in CHARLS. A rapid eGFR decline was defined as an average annual eGFR decline of >3 mL/min/1.73 m². The associations between rapid eGFR decline and MetS recovery/development were analysed using multivariable adjusted logistic models.

RESULTS

According to MetS baseline status and follow-up, participants were divided into four groups: (1) 2460 (59.4%) in the MetS-free group, (2) 361 (8.7%) in the MetS-developed group, (3) 499 (12.0%) in the MetS recovery group and (4) 822 (19.8%) in the MetS chronic group. When compared with the MetS chronic group, the multivariable adjusted OR of rapid eGFR decline in the MetS recovery group was 0.64 (OR: 0.64; 95% CI 0.45 to 0.90, p=0.01). In contrast, when compared with the MetS-free group, the multivariable adjusted OR of rapid eGFR decline in the MetS-developed group was 1.00 (OR: 1.00; 95% CI 0.73 to 1.38, p=0.98).

CONCLUSIONS

Over the 4-year follow-up period, we found that MetS recovery was associated with a reduced risk of rapid eGFR decline in middle-aged and older adults, while MetS occurrence was not related to rapid eGFR decline. Recovery from MetS appeared to protect against a rapid decline in eGFR.

Predictive Value of HbA1c and Metabolic Syndrome for Renal Outcome in Non-Diabetic CKD Stage 1-4 Patients

Glycated hemoglobin (HbA1c) levels are commonly used to indicate long-term glycemic control. An HbA1c level of 6.5−5.7% is defined as pre-diabetes and is proposed as a criterion for diagnosing metabolic syndrome (MetS). However, HbA1c levels can be affected by chronic kidney disease (CKD). Whether HbA1c is associated with clinical outcomes in nondiabetic CKD patients with or without MetS is still unknown. This study included 1270 nondiabetic CKD stage 1−4 Asian patients, divided by HbA1c and MetS. Through linear regression, HbA1c was positively associated with age, waist circumference, hemoglobin levels, and C-reactive protein and was negatively associated with malnutrition−inflammation. HbA1c levels were 5.5% (0.6%) and 5.7% (0.6%) in non-MetS and MetS, respectively (p < 0.001). In Cox regression, higher-level HbA1c was associated with worse composite renal outcome in MetS patients, but with better renal outcome in non-MetS patients: Hazard ratio (HR) (95% confidence interval [CI]) of HbA1c ≥5.7%, compared with HbA1c <5%, was 2.00 (1.06−3.78) in MetS and 0.25 (0.14−0.45) in non-MetS. An association between HbA1c and all-cause mortality was not found. In conclusion, higher HbA1c levels are associated with worse renal outcomes in nondiabetic CKD stage 1−4 patients modified by the presence of MetS.

Metabolic Syndrome-Related Kidney Injury: A Review and Update

Metabolic syndrome (MetS) includes visceral obesity, hyperglycemia, dyslipidemia, and hypertension. The prevalence of MetS is 20-25%, which is an important risk factor for chronic kidney disease (CKD). MetS causes effects on renal pathophysiology, including glomerular hyperfiltration, RAAS, microalbuminuria, profibrotic factors and podocyte injury. This review compares several criteria of MetS and analyzes their differences. MetS and the pathogenesis of CKD includes insulin resistance, obesity, dyslipidemia, inflammation, oxidative stress, and endothelial dysfunction. The intervention of MetS-related renal damage is the focus of this article and includes controlling body weight, hypertension, hyperglycemia, and hyperlipidemia, requiring all components to meet the criteria. In addition, interventions such as endoplasmic reticulum stress, oxidative stress, gut microbiota, body metabolism, appetite inhibition, podocyte apoptosis, and mesenchymal stem cells are reviewed.

The Impact of Hepatitis C Virus, Metabolic Disturbance, and Unhealthy Behavior on Chronic Kidney Disease: A Secondary Cross-Sectional Analysis

BACKGROUND

Hepatitis C virus (HCV) infection is associated with a higher risk of chronic kidney disease (CKD). This study investigates the relationship among HCV, CKD, and understudied confounders, such as unhealthy behaviors and metabolic disturbances.

METHODS

This cross-sectional study was conducted as part of a community health promotion program in an HCV endemic area of Taiwan from June to December 2019. Multivariable logistic regression analyses adjusted for demographic and clinical characteristics were performed to investigate the association between CKD and HCV seropositivity.

RESULTS

Of 2387 participants who underwent health check-ups, the mean age was 64.1 years old; females predominated (63.2%), and 306 (12.8%) subjects were seropositive for HCV. CKD, defined as a lower estimated glomerular filtration rate (eGFR) was associated with unhealthy dietary habits, metabolic syndrome, and HCV. Less frequent exercise, higher waist circumference (WC) and HbA1c all affected risk of CKD; HCV increased risk of CKD by 44% compared to non-HCV (OR 1.44, 95% confidence interval (CI) 1.05-1.98) in the multivariable analysis. In the HCV group, lower eGFR was also significantly associated with the severity of metabolic syndrome (MetS) (median eGFR was 86.4, 77.1, and 64.5 mL/min/1.73 m² for individuals with three and five MetS components, respectively).

CONCLUSIONS

Beyond metabolic disturbance and irregular exercise, HCV seropositivity is independently associated with CKD in a community survey. Healthy lifestyle promotion might protect against renal function decline in HCV; however, the mechanisms underlying the association need further large-scale investigation.

Metabolic syndrome and cardiovascular diseases: Going beyond traditional risk factors

Metabolic syndrome (MS) is a chronic non-infective syndrome characterised clinically by a set of vascular risk factors that include insulin resistance, hypertension, abdominal obesity, impaired glucose metabolism, and dyslipidaemia. These risk factors are due to a pro-inflammatory state, oxidative stress, haemodynamic dysfunction, and ischaemia, which overlap in 'dysmetabolic' patients. This review aimed to evaluate the relationship between the traditional components of MS with cardiovascular disease (CVD), inflammation, and oxidative stress. MEDLINE-PubMed, EMBASE, and Cochrane databases were searched. Chronic low-grade inflammatory states and metaflammation are often accompanied by metabolic changes directly related to CVD incidence, such as diabetes mellitus, hypertension, and obesity. Moreover, the metaflammation is characterised by an increase in the serum concentration of pro-inflammatory cytokines, mainly interleukin-1 β (IL-1β), IL-6, and tumour necrosis factor-α (TNF-α), originating from the chronically inflamed adipose tissue and associated with oxidative stress. The increase of reactive oxygen species overloads the antioxidant systems causing post-translational alterations of proteins, lipids, and DNA leading to oxidative stress. Hyperglycaemia contributes to the increase in oxidative stress and the production of advanced glycosylation end products (AGEs) which are related to cellular and molecular dysfunction. Oxidative stress and inflammation are associated with cellular senescence and CVD. CVD should not be seen only as being triggered by classical MS risk factors. Atherosclerosis is a multifactorial pathological process with several triggering and aetiopathogenic mechanisms. Its medium and long-term repercussions, however, invariably constitute a significant cause of morbidity and mortality. Implementing preventive and therapeutic measures against oxy-reductive imbalances and metaflammation states has unquestionable potential for favourable clinical outcomes in cardiovascular medicine.

Prevalence and associations of metabolic syndrome in patients with alcohol use disorder

Excessive alcohol consumption has been associated with different components of the metabolic syndrome (MetS) such as arterial hypertension, dyslipidemia, type 2 diabetes or obesity. We aimed to analyze the prevalence and associations of MetS in patients with Alcohol Use Disorder (AUD). Cross-sectional study in heavy drinkers admitted for the treatment of AUD between 2013 and 2017. Medical comorbidity, anthropometric data, alcohol use and biological parameters were obtained. MetS was established according to the harmonized definition. A total of 728 patients (22% women) were included; median age was 47 years (IQR: 40–53.5), median alcohol consumption was 160 g/day (IQR: 115–240) and prevalence of MetS was 13.9%. The multivariate analysis showed a significant dose–response effect of estimated glomerular filtration (eGFR) and MetS: relative to patients with eGFR > 90 mL/min, those with eGFR (60–90 mL/min) and those with eGFR < 60 mL/min were 1.93 times (95% CI 1.18–3.15) and 5.61 times (95% CI 1.66–19.0) more likely to have MetS, respectively. MetS was significantly associated with hyperuricemia (OR 2.28, 95% CI 1.36–3.82) and elevated serum GGT (OR 3.67, 95% CI 1.80–7.46). Furthermore, for every increase of 1 year in age, the probability of MetS increased significantly (OR 1.03, 95% CI 1.01–1.05). MetS in heavy drinkers is independently associated with reduced kidney function and metabolic risk factors including hyperuricemia and elevated serum GGT.

Metabolic syndrome severity score and the progression of CKD

BACKGROUND

Metabolic syndrome severity, expressed by the continuous metabolic syndrome risk score (MetS score), has been demonstrated to be able to predict future health conditions. However, little is known about the association between MetS score and renal function.

METHODS

A total of 22,719 participants with normal renal function abstracted from the Kailuan Study were followed from 2006 to 2016. The new onset of chronic kidney disease (CKD) was defined as eGFR <60 ml/min per 1.73 m² and/or proteinuria >300 mg/dl. Progressive decline in renal function was defined as an annual change rate of eGFR below the 10th percentile of the whole population.

RESULTS

In the multivariate-adjusted model, we found that the risk of progressive decline in renal function increased consistently with the MetS score, with an odds ratio of 1.49 (95% CI, 1.28, 1.73) for those subjects>75th percentile compared with those <25th percentile. Additionally, a high MetS score was found to be associated with an increased risk of CKD, with a hazard ratio of 1.53 (95% CI, 1.33, 1.78) for subjects >75th percentile compared with those <25th percentile.

CONCLUSIONS

Our findings suggested that the MetS score was associated with an increased risk of a progressive decline in renal function and was also a strong and independent risk factor for the development of CKD. These findings provide evidence of the potential clinical utility of the MetS score for assessing metabolic syndrome severity to detect the risk of decreased renal function and CKD.

Incidence and correlation of metabolic syndrome and kidney stones in a healthy screening population

Background

To study the incidence of metabolic syndrome (MetS) and kidney stones in a healthy screening population and to explore the correlation between them.

Methods

The physical examination data of 11,827 people screened at the First Affiliated Hospital of Soochow University from August 2019 to July 2020 were analyzed. MetS diagnostic criteria were based on the 2004 guidelines of Chinese Diabetes Society (CDS). Multivariate logistic regression was used to analyze the correlation between MetS and various characteristics and kidney stones. Trend analysis was represented by P value, and P<0.05 indicated statistical significance.

Results

The present study comprised 6,570 males (55.6%, aged 46.15±13.653 years) and 5,257 females (44.4%, aged 41.41±11.712 years). Of these, 1,036 (8.8%) had kidney stones and 1,552 (13.1%) had MetS. Among the MetS patients, 35.1% had a body mass index (BMI) ≥25, 27.7% had hypertension, 10.8% had hyperglycemia, and 31.2% had dyslipidemia. Kidney stone morbidity was 14.5% in the MetS group and 7.9% in the non-MetS group (P<0.05). As the number of MetS characteristics increased, kidney stone morbidity showed a linear increasing trend (P<0.05 for trend). With an increase in BMI and blood triglycerides (TG), and a decrease in lipoprotein cholesterol (HDL-C), the incidence of kidney stones had an increasing trend (P<0.05 for trend). Sex, age and MetS were independent risk factors for the occurrence of kidney stones, with and odds ratio (OR) of 1.493 [95% confidence interval (CI): 1.264–1.763] for MetS. Of the MetS characteristics, BMI ≥25 and blood pressure (BP) ≥140/90 mmHg were independent risk factors for kidney stones, with OR values of 1.209 (95% CI: 1.047–1.396) and 1.248 (95% CI: 1.071–1.453), respectively.

Conclusions

MetS is an independent risk factor for kidney stones. Appropriate medication and dietary advice may help to correct urinary metabolic abnormalities and prevent the recurrence of kidney stones.

Metabolic Syndrome, Homocysteine and uric acid in patients with obesity; experience from Obesity and Work Centre

BACKGROUND: Uric acid (UA) and homocysteine (HCys) are involved in cardiovascular diseases. Patients with obesity (PwO) are characterized by elevated cardiovascular risk. OBJECTIVE: To evaluate the relationship between HCys and UA concentrations in 1141 overweight patients and PwO with and without metabolic syndrome (MS). METHODS: MS was defined according to IDF criteria (2005). Anthropometric data were recorded and blood biochemical parameters were assessed with routine methods on fasting blood samples. Statistics: Spearman correlation and multiple regression analysis. RESULTS: Gender, obesity and MS influenced both UA and HCys levels, which were increased in males, MS patients, PwO with MS and positively correlated (p < 0.001). Patients without MS had normal or slightly high levels. Hypertension, hyperuricemia and hyperhomocysteinemia were found in PwO with MS. UA concentration correlated with systolic blood pressure, triglycerides and HDL (all p < 0.05). Multivariate analysis showed that HCys concentration was an independent determinant factor affecting UA levels (T value 3.5, p < 0.001). CONCLUSIONS: HCys and UA levels positively and significantly correlated in PwO, especially in those with MS. The significant correlation between UA and hypertension, triglycerides, HDL suggests the clinical usefulness of monitoring UA together with HCys concentrations as cardiovascular risk marker in these patients.

Association of Metabolic Syndrome and Chronic Kidney Disease in Moroccan Adult Population

Background: Metabolic syndrome (MetS) is a cluster of cardiovascular risk factors that may promote the development of chronic kidney disease (CKD). The aim of this research was to determine the prevalence of MetS and its components and, to study their association with CKD among Moroccan adult population living in an agricultural province. Materials and Methods: The study involved 210 adult participants of 18 and over years, of both sexes, sampled from urban and rural areas of Sidi Bennour province in Morocco. Systolic and diastolic blood pressure, weight, height, and waist circumference were measured and body mass index (BMI) was calculated. Blood total cholesterol, triglycerides, glucose, and serum creatinine were determined. Subsequent glomerular filtration rate (GFR) was estimated by the modification of diet in renal disease formula and the CKD was defined by an estimated GFR (eGFR) <60 mL/min/1.73 m². The diagnosis of MetS was based on the National Cholesterol Education Program/Adult Treatment Panel (NCEP ATP III) report. Results: The mean age of the participants was 54.18 ± 13.45 years, the prevalence of MetS and CKD were 38% and 4.4%, respectively. Abdominal obesity was the strongest risk factor of MetS among the studied population (71%), followed by increased fasting plasma glucose (40.5%), high blood pressure (35.2%), hypercholesterolemia (31.0%), and hypertriglyceridemia (23.8%). The prevalence of these comorbid factors increased with age (P = 0.000), BMI (P = 0.000), and decreased with education level (P = 0.012). The presence of MetS was significantly associated with decreased eGFR (P = 0.022), hence the prevalence of CKD was markedly greater in subjects with MetS than those without. Conclusions: Our finding indicates that MetS is a serious public health problem in the study population and that its individual components are involved in decreasing the eGFR and the progression of renal dysfunction. The study results support the need of the development of a strategy to control and prevent worsening of the MetS individual components and development of CKD.

The prevalence and associated factors of metabolic syndrome in Chinese aging population

Metabolic syndrome (MetS) is hitting high notes in the aging society in China. However, the prevalence and associated factors in Chinese aging population lack clarity to some extent. In the present study, we projected to inquire into the prevalence of MetS and its associated factors by analyzing datasets downloaded from the China Health and Retirement Longitudinal Study (CHARLS). Data comprising age, gender, socioeconomic status, lifestyle and health behaviors as well as blood biomarkers were subjected to descriptive statistics followed by univariate logistic regression and multivariate logistic regression. The overall prevalence of MetS was 33.38% (95% CI 32.42–34.34%). With age augments, prevalence increased during 40–70 years, while declined in participants aged 70 years above. Females had 2.94 times of risks (95% CI 2.55–3.39, P < 0.001). Marital status and alcohol consumption contributed nothing to the suffering of MetS. Participants with GDP per capita > 10,000 RMB and a non-agricultural hukou sustained higher risks than other participants (P < 0.05). Participants under education of middle school suffered 1.16 times of risks than other level of education (95% CI 1.01–1.34, P < 0.05). Smokers, participants with high low-density lipoprotein (LDL) or hyperuricemia or high glycosylated hemoglobin HbA1c sustained increased risks (P < 0.05). In Chinese aging population, with the augment of age, the prevalence ascended in men, while descended in women and was interfered by socioeconomic status, lifestyle and health behaviors as well as blood biomarkers, but not marital status and alcohol consumption.

Role of Endourological Procedures (PCNL and URS) on Renal Function: a Systematic Review

PURPOSE OF REVIEW

To present the latest evidence related to the impact of ureteroscopy (URS) and percutaneous nephrolithotomy (PCNL) on the renal function.

RECENT FINDINGS

Our review suggests that the overall renal function is not detrimentally affected by endourological interventions (URS, PCNL). This is however influenced by the preoperative renal function, presence of comorbidities such as diabetes and hypertension. For PCNL procedures, tract multiplicity, preoperative UTI, and postoperative bleeding also contribute to a decline in renal function. This review suggests that endourological interventions do not adversely affect renal function and tend to improve it in patients who do not have a poor renal function prior to the procedure. Several factors including poor preoperative renal function, diabetes, hypertension, and multiple percutaneous tracts appear to predispose patients to declining renal function after procedure, and these patients should be counseled for and followed up appropriately.