Metabolic syndrome and renal failure: Similarities and differences

Research output: Contribution to journalArticle

10 Citations (Scopus)

Abstract

The metabolic syndrome (MS) and chronic kidney disease (CKD) share many similar risk factors for cardiovascular disease. Both are associated with increased triglyceride (TG) levels, both associated with increased small dense low density lipoprotein (LDL), both with decreased high density lipoprotein (HDL) levels, in both cases HDL particle size is reduced. The TG content of HDL and very low density lipoprotein (VLDL) and remnants are increased, resulting in a dyslipidemia. Both are associated with increased inflammation, a hypercoagulable state and insulin resistance. Establishing whether these similarities are the result of identical biological processes or instead represent similar end results of different processes is further confounded by the associated both of adiposity and of MS with the incidence and progression of renal failure. Differences are present however. In MS hepatic VLDL synthesis is increased driven by increased flux of free fatty acids from muscle, adipose tissue and gut to the liver. VLDL is catabolized to LDL and the transfer of TG to HDL by cholesterol ester transfer protein destabilizes HDL leading to its rapid clearance. In CKD HDL fails to mature due to reduced activity of lecithin cholesterol transfer protein. In MS inflammation primarily arises from increased visceral adipose tissue, while inflammation is largely unrelated to body composition in CKD. Increased production of TG rich lipoproteins predominates in MS, while decreased disposal of TG rich proteins predominates as the cause of increased TG levels in CKD. Whether treatment of elements of MS, with the exception of hypertension, will avoid the onset and progression of renal failure is unknown.

Original languageEnglish (US)
Pages (from-to)151-164
Number of pages14
JournalPanminerva Medica
Volume48
Issue number3
StatePublished - Sep 2006

Fingerprint

Renal Insufficiency
HDL Lipoproteins
Triglycerides
Chronic Renal Insufficiency
VLDL Lipoproteins
Inflammation
Phospholipid Transfer Proteins
Cholesterol Ester Transfer Proteins
Biological Phenomena
Intra-Abdominal Fat
Liver
Adiposity
Dyslipidemias
Body Composition
LDL Lipoproteins
Particle Size
Nonesterified Fatty Acids
HDL Cholesterol
Lipoproteins
Insulin Resistance

Keywords

  • Apolipoproteins
  • Cholesterol ester transfer protein
  • Cholesterol-HDL
  • Cholesterol-LDL
  • Cholesterol-VLDL
  • Hepatic lipase
  • Lecithin cholesterol transfer protein
  • Lipoprotein lipase
  • Remnants

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Metabolic syndrome and renal failure : Similarities and differences. / Kaysen, George.

In: Panminerva Medica, Vol. 48, No. 3, 09.2006, p. 151-164.

Research output: Contribution to journalArticle

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