Síndrome metabólico en el paciente renal. Revisión bibliográfica

Antonio José Martín Hurtado; Carmen Morales Cuenca; Raquel Espejo Rodríguez; Rodolfo Crespo Montero

doi:10.37551/S2254-28842024029

Portada Volumen 27 número 4 de la revista Enfermería Nefrológica de 2024

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29 julio 2024

Publicado

30 diciembre 2024

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Resumen

Introducción: En los últimos años, la enfermedad renal crónica ha aumentado su prevalencia mundial, y las comorbilidades asociadas a su aparición, en numerosas ocasiones relacionadas con el síndrome metabólico, acentúan su desarrollo. Las enfermedades desencadenantes del síndrome metabólico han adquirido un preocupante carácter epidemiológico en la sociedad actual.
Objetivos: Revisar y sintetizar la bibliografía científica en relación el síndrome metabólico en el paciente renal crónico.
Metodología: Se ha realizado una revisión bibliográfica con búsqueda sistematizada a través de las bases de datos PubMed y Scopus. Se incluyeron artículos que referenciaran los diferentes componentes del síndrome metabólico en pacientes con patología renal, y cuya publicación estuviese comprendida entre 2019 y 2024 en inglés y español.
Resultados: Se seleccionaron 18 artículos entre los que se encuentran revisiones sistemáticas y estudios observacionales. Tras el análisis de estos, emergieron las siguientes temáticas: las alteraciones que conforman el síndrome metabólico y su influencia en la enfermedad renal crónica, la aparición del síndrome metabólico y su prevalencia, así como las medidas de prevención.
Conclusiones: Se evidencia una elevada correlación entre la existencia de enfermedades incluidas en el síndrome metabólico y el desarrollo de enfermedad renal. Entre ellos la hipertensión arterial y la diabetes mellitus destacan por encima de la obesidad y las dislipemias. La prevención y el diagnóstico precoz son considerados los mejores tratamientos.

Palabras clave

nefropatías hipertensión arterial enfermedad renal crónica diabetes mellitus obesidad síndrome metabólico

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Derechos de autor 2024 Antonio José Martín , Carmen Morales, Raquel, Rodolfo Crespo Montero

Esta obra está bajo una licencia internacional Creative Commons Atribución-NoComercial 4.0.

Aviso de derechos de autor/a

© Los autores ceden de forma no exclusiva los derechos de explotación de los trabajos publicados y consiente en que su uso y distribución se realice con la Licencia Creative Commons Atribución - No comercial 4.0 Internacional (CC BY-NC 4.0). Puede consultar desde aquí la versión informativa y el texto legal de la licencia. Esta circunstancia ha de hacerse constar expresamente de esta forma cuando sea necesario.

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Martín Hurtado AJ, Morales Cuenca C, Espejo Rodríguez R, Crespo Montero R. Síndrome metabólico en el paciente renal. Revisión bibliográfica. Enferm Nefrol [Internet]. 2024 [consultado 23 Abr 2025];27(4):[aprox. 11 p.]. Disponible en: https://enfermerianefrologica.com/revista/article/view/4794

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Referencias

Registro Español de Enfermos Renales (REER). [consultado 21 May 2024]. Disponible en: https://www.ont.es/informacion-a-los-profesionales-4/registros-de-donacion-de-trasplantes-4-9/registro-espanol-de-enfermos-renales-4-9-4/.
García-Trabanino R, Hernández C, Rosa A, Domínguez Alonso J. Incidencia, mortalidad y prevalencia de enfermedad renal crónica terminal en la región del Bajo Lempa, El Salvador: 10 años de registro comunitario. Nefrologia 2016;36:517-22.
Martínez-Castelao A, Górriz JL, Bover J, Segura-de la Morena J, Cebollada J, Escalada J, et al. Documento de consenso para la detección y manejo de la enfermedad renal crónica. Aten Primaria 2014;46:501-19.
KDIGO 2024 Clinical Practice Guideline for the Evaluation and Management of Chronic Kidney Disease. Kidney Int. 2024;105(4S):S117314.
McCracken E, Monaghan M, Sreenivasan S. Pathophysiology of the metabolic syndrome. Clin Dermatol. 2018; 36:14-20.
Khan SR. Is oxidative stress, a link between nephrolithiasis and obesity, hypertension, diabetes, chronic kidney disease, metabolic syndrome? Urol Res. 2012;40: 95-112.
Lei X, Wen H, Xu Z. Higher oxidative balance score is associated with lower kidney stone disease in US adults: a population-based cross-sectional study. World J Urol. 2024;42(1):222.
Kim Y-J, Park MS, Kim W-T, Yun S-J, Kim W-J, Lee S-C. Hypertension influences recurrent stone formation in nonobese stone formers. Urology. 2011;77:1059-63.
Muzica CM, Sfarti C, Trifan A, Zenovia S, Cuciureanu T, Nastasa R et al. Nonalcoholic fatty liver disease and type 2 diabetes mellitus: A bidirectional relationship. Can J Gastroenterol Hepatol. 2020;2020:6638306.
Hutton B, Catalá-López F, Moher D. La extensión de la declaración PRISMA para revisiones sistemáticas que incorporan metaanálisis en red: PRISMA-NMA. Med Clin. (Barc) 2016;147:262-6.
STROBE [Internet]. [Consultado 22 May 2024]. Checklists. Disponible en: https://www.strobe-statement.org/
chec-klists/.
Santamaría R. Programa de Habilidades en Lectura Crítica Español (CASPe). NefroPlus. 2017;9(1):100-1.
Handelsman Y, Butler J, Bakris GL, DeFronzo RA, Fonarow GC, Green JB et al. Early intervention and intensive management of patients with diabetes, cardiorenal, and metabolic diseases. J Diabetes Complications. 2023;37:108389.
Martín-Moreno PL, Shin H-S, Chandraker A. Obesity and post-transplant diabetes mellitus in kidney transplantation. J Clin Med. 2021;10:2497.
Bagasrawala SI, Sheth H, Shah H, Ansari R, Lakdawala M. Metabolic syndrome rather than obesity alone is more significant for kidney disease. Obes Surg. 2019;29:3478-83.
Li H, Wang Q, Ke J, Lin W, Luo Y, Yao J et al. Optimal obesity- and lipid-related indices for predicting metabolic syndrome in chronic kidney disease patients with and without Type 2 diabetes mellitus in China. Nutrients. 2022;14:1334.
Ammirati AL. Chronic kidney disease. Rev Assoc Med Bras 2020;66:S3-9.
Bikbov B, Purcell CA, Levey AS, Smith M, Abdoli A, Abebe M et al. Global, regional, and national burden of chronic kidney disease, 1990–2017: a systematic analysis for the Global Burden of Disease Study 2017. Lancet. 2020;395:709-33.
Fwu C-W, Schulman IH, Lawrence JM, Kimmel PL, Eggers P, Norton J et al. Association of obesity, metabolic syndrome, and diabetes with urinary incontinence and chronic kidney disease: Analysis of the national health and nutrition examination survey, 2003-2020. J Urol. 2024;211:124-33.
Varra F-N, Varras M, Varra V-K, Theodosis-Nobelos P. Molecular and pathophysiological relationship between obesity and chronic inflammation in the manifestation of metabolic dysfunctions and their inflammation-mediating treatment options (Review). Mol Med Rep. 2024;29(6):95.
Park S, Lee S, Kim Y, Lee Y, Kang MW, Han K et al. Reduced risk for chronic kidney disease after recovery from metabolic syndrome: A nationwide population-based study. Kidney Res Clin Pract. 2020;39:180-91.
Sim R, Chong CW, Loganadan NK, Fong AYY, Navaravong L, Hussein Z et al. Comparative effectiveness of cardiovascular, renal and safety outcomes of second-line antidiabetic drugs use in people with type 2 diabetes: A systematic review and network meta-analysis of randomised controlled trials. Diabet Med. 2022;39(3):e14780.
Schwartz P, Capotondo MM, Quaintenne M, Musso-Enz GM, Aroca-Martinez G, Musso CG. Obesity and glomerular filtration rate. Int Urol Nephrol. 2023;56:1663-8.
Scurt FG, Ganz MJ, Herzog C, Bose K, Mertens PR, Chatzikyrkou C. Association of metabolic syndrome and chronic kidney disease. Obes Rev. 2024;25(1):1-16.
Petramala L, Gigante A, Sarlo F, Servello A, Circosta F, Marino L et al. Relevance of obesity-related organ damage and metabolic syndrome classification in cardiovascular and renal risk stratification in patients with essential hypertension. Front Cardiovasc Med. 2024;28;11:1369090.
Xu Q, Fan X, Chen G, Ma J, Ye W, Ai S et al. New-onset metabolic syndrome is associated with accelerated renal function decline partially through elevated uric acid: an epidemiological cohort study. Front Endocrinol (Lausanne). 2024;15:1328404.
Fanaei SM, Mehran L, Amouzegar A, Masoumi S, Amouzegar A, Azizi F. The impact of metabolic syndrome on chronic kidney disease development. Insights from a big prospective study. Eur J Clin Invest. 2023;53(4):e13945.
Moreira AD, Velasquez-Melendez G, Ladeira RM, da Silva Junior GB, Fonseca M de J, Barreto SM. Association between adiposity indexes and kidney disease: Findings from the longitudinal study of adult health (Elsa-Brazil). J Am Nutr Assoc. 2022;41:275-80.
Chen I-J, Hsu L-T, Lu M-C, Chen Y-J, Tsou M-T, Chen J-Y. Gender differences in the association between obesity indices and chronic kidney disease among middle-aged and elderly Taiwanese population: A community-based cross-sectional study. Front Endocrinol (Lausanne). 2021; 12.
Comini L de O, de Oliveira LC, Borges LD, Dias HH, Batistelli CRS, da Silva LS et al. Individual and combined components of metabolic syndrome with chronic kidney disease in individuals with hypertension and/or diabetes mellitus accompanied by primary health care. Diabetes Metab Syndr Obes. 2020;13:71-80.
Crespo JJ, Piñeiro L, Otero A, Castiñeira C, Ríos MT, Regueiro A et al. Administration-time-dependent effects of hypertension treatment on ambulatory blood pressure in patients with chronic kidney disease. Chronobiol Int. 2013;30:159-75.
Yang H, Cui Z, Quan Z. Effects of metabolic syndrome and its components on chronic kidney disease and renal function: A two-sample Mendelian randomization study. Metab Syndr Relat Disord. 2024;22:114-22.
Rodríguez-Rodríguez R, Hornum M, Rodríguez Rodríguez AE, Bevc S, Trevisani F, Fernández G et al. Renal disease in metabolic syndrome: The hidden role of intrarenal ischemia. Kidney Int Rep. 2024;9:1419-28.
Kang SY, Lee YH, Jeong SJ, Kim JS, Jeong KH, Hwang HS. How obesity and metabolic syndrome affect cardiovascular events, progression to kidney failure and all-cause mortality in chronic kidney disease. Nephrol Dial Transplant. 2024;39:778-87.
Yang J, Lee HS, Lim CY, et al. Impact of obesity on renal function in elderly Korean adults: a national population-based cohort study. Kidney Research and Clinical Practice. 2024;j.krcp23.187.
Oh H, Quan SA, Jeong J-Y, Jang S-N, Lee JE, Kim D-H. Waist circumference, not body mass index, is associated with renal function decline in Korean population: Hallym aging study. PLoS One. 2013;8:e59071.
Wang L, Du H, Sheng C, Dai H, Chen K. Association between metabolic syndrome and kidney cancer risk: a prospective cohort study. Lipids Health Dis. 2024;17;23(1)142.
Perreault L, Pan Q, Aroda VR, Barrett-Connor E, Dabelea D, Dagogo-Jack S et al. Exploring residual risk for diabetes and microvascular disease in the Diabetes Prevention Program Outcomes Study (DPPOS). Diabet Med. 2017;34:1747-55.
Malheiro LFL, Fernandes MM, Oliveira CA, Barcelos I de S, Fernandes AJV, Silva BS et al. Renoprotective mechanisms of exercise training against acute and chronic renal diseases – A perspective based on experimental studies. Life Sci. 2024;346:122628.
Nataraj M, Maiya GA, Nagaraju SP, Shastry BA, Shivashankara KN, Shetty S et al. Effect of exercise-based rehabilitation on functional capacity and renal function in type 2 diabetes mellitus with nephropathy: a randomized controlled trial. Int Urol Nephrol. 2024;56(8):2671-82.

Referencias

Registro Español de Enfermos Renales (REER). [consultado 21 May 2024]. Disponible en: https://www.ont.es/informacion-a-los-profesionales-4/registros-de-donacion-de-trasplantes-4-9/registro-espanol-de-enfermos-renales-4-9-4/.

García-Trabanino R, Hernández C, Rosa A, Domínguez Alonso J. Incidencia, mortalidad y prevalencia de enfermedad renal crónica terminal en la región del Bajo Lempa, El Salvador: 10 años de registro comunitario. Nefrologia 2016;36:517-22.

Martínez-Castelao A, Górriz JL, Bover J, Segura-de la Morena J, Cebollada J, Escalada J, et al. Documento de consenso para la detección y manejo de la enfermedad renal crónica. Aten Primaria 2014;46:501-19.

KDIGO 2024 Clinical Practice Guideline for the Evaluation and Management of Chronic Kidney Disease. Kidney Int. 2024;105(4S):S117314.

McCracken E, Monaghan M, Sreenivasan S. Pathophysiology of the metabolic syndrome. Clin Dermatol. 2018; 36:14-20.

Khan SR. Is oxidative stress, a link between nephrolithiasis and obesity, hypertension, diabetes, chronic kidney disease, metabolic syndrome? Urol Res. 2012;40: 95-112.

Lei X, Wen H, Xu Z. Higher oxidative balance score is associated with lower kidney stone disease in US adults: a population-based cross-sectional study. World J Urol. 2024;42(1):222.

Kim Y-J, Park MS, Kim W-T, Yun S-J, Kim W-J, Lee S-C. Hypertension influences recurrent stone formation in nonobese stone formers. Urology. 2011;77:1059-63.

Muzica CM, Sfarti C, Trifan A, Zenovia S, Cuciureanu T, Nastasa R et al. Nonalcoholic fatty liver disease and type 2 diabetes mellitus: A bidirectional relationship. Can J Gastroenterol Hepatol. 2020;2020:6638306.

Hutton B, Catalá-López F, Moher D. La extensión de la declaración PRISMA para revisiones sistemáticas que incorporan metaanálisis en red: PRISMA-NMA. Med Clin. (Barc) 2016;147:262-6.

STROBE [Internet]. [Consultado 22 May 2024]. Checklists. Disponible en: https://www.strobe-statement.org/

chec-klists/.

Santamaría R. Programa de Habilidades en Lectura Crítica Español (CASPe). NefroPlus. 2017;9(1):100-1.

Handelsman Y, Butler J, Bakris GL, DeFronzo RA, Fonarow GC, Green JB et al. Early intervention and intensive management of patients with diabetes, cardiorenal, and metabolic diseases. J Diabetes Complications. 2023;37:108389.

Martín-Moreno PL, Shin H-S, Chandraker A. Obesity and post-transplant diabetes mellitus in kidney transplantation. J Clin Med. 2021;10:2497.

Bagasrawala SI, Sheth H, Shah H, Ansari R, Lakdawala M. Metabolic syndrome rather than obesity alone is more significant for kidney disease. Obes Surg. 2019;29:3478-83.

Li H, Wang Q, Ke J, Lin W, Luo Y, Yao J et al. Optimal obesity- and lipid-related indices for predicting metabolic syndrome in chronic kidney disease patients with and without Type 2 diabetes mellitus in China. Nutrients. 2022;14:1334.

Ammirati AL. Chronic kidney disease. Rev Assoc Med Bras 2020;66:S3-9.

Bikbov B, Purcell CA, Levey AS, Smith M, Abdoli A, Abebe M et al. Global, regional, and national burden of chronic kidney disease, 1990–2017: a systematic analysis for the Global Burden of Disease Study 2017. Lancet. 2020;395:709-33.

Fwu C-W, Schulman IH, Lawrence JM, Kimmel PL, Eggers P, Norton J et al. Association of obesity, metabolic syndrome, and diabetes with urinary incontinence and chronic kidney disease: Analysis of the national health and nutrition examination survey, 2003-2020. J Urol. 2024;211:124-33.

Varra F-N, Varras M, Varra V-K, Theodosis-Nobelos P. Molecular and pathophysiological relationship between obesity and chronic inflammation in the manifestation of metabolic dysfunctions and their inflammation-mediating treatment options (Review). Mol Med Rep. 2024;29(6):95.

Park S, Lee S, Kim Y, Lee Y, Kang MW, Han K et al. Reduced risk for chronic kidney disease after recovery from metabolic syndrome: A nationwide population-based study. Kidney Res Clin Pract. 2020;39:180-91.

Sim R, Chong CW, Loganadan NK, Fong AYY, Navaravong L, Hussein Z et al. Comparative effectiveness of cardiovascular, renal and safety outcomes of second-line antidiabetic drugs use in people with type 2 diabetes: A systematic review and network meta-analysis of randomised controlled trials. Diabet Med. 2022;39(3):e14780.

Schwartz P, Capotondo MM, Quaintenne M, Musso-Enz GM, Aroca-Martinez G, Musso CG. Obesity and glomerular filtration rate. Int Urol Nephrol. 2023;56:1663-8.

Scurt FG, Ganz MJ, Herzog C, Bose K, Mertens PR, Chatzikyrkou C. Association of metabolic syndrome and chronic kidney disease. Obes Rev. 2024;25(1):1-16.

Petramala L, Gigante A, Sarlo F, Servello A, Circosta F, Marino L et al. Relevance of obesity-related organ damage and metabolic syndrome classification in cardiovascular and renal risk stratification in patients with essential hypertension. Front Cardiovasc Med. 2024;28;11:1369090.

Xu Q, Fan X, Chen G, Ma J, Ye W, Ai S et al. New-onset metabolic syndrome is associated with accelerated renal function decline partially through elevated uric acid: an epidemiological cohort study. Front Endocrinol (Lausanne). 2024;15:1328404.

Fanaei SM, Mehran L, Amouzegar A, Masoumi S, Amouzegar A, Azizi F. The impact of metabolic syndrome on chronic kidney disease development. Insights from a big prospective study. Eur J Clin Invest. 2023;53(4):e13945.

Moreira AD, Velasquez-Melendez G, Ladeira RM, da Silva Junior GB, Fonseca M de J, Barreto SM. Association between adiposity indexes and kidney disease: Findings from the longitudinal study of adult health (Elsa-Brazil). J Am Nutr Assoc. 2022;41:275-80.

Chen I-J, Hsu L-T, Lu M-C, Chen Y-J, Tsou M-T, Chen J-Y. Gender differences in the association between obesity indices and chronic kidney disease among middle-aged and elderly Taiwanese population: A community-based cross-sectional study. Front Endocrinol (Lausanne). 2021; 12.

Comini L de O, de Oliveira LC, Borges LD, Dias HH, Batistelli CRS, da Silva LS et al. Individual and combined components of metabolic syndrome with chronic kidney disease in individuals with hypertension and/or diabetes mellitus accompanied by primary health care. Diabetes Metab Syndr Obes. 2020;13:71-80.

Crespo JJ, Piñeiro L, Otero A, Castiñeira C, Ríos MT, Regueiro A et al. Administration-time-dependent effects of hypertension treatment on ambulatory blood pressure in patients with chronic kidney disease. Chronobiol Int. 2013;30:159-75.

Yang H, Cui Z, Quan Z. Effects of metabolic syndrome and its components on chronic kidney disease and renal function: A two-sample Mendelian randomization study. Metab Syndr Relat Disord. 2024;22:114-22.

Rodríguez-Rodríguez R, Hornum M, Rodríguez Rodríguez AE, Bevc S, Trevisani F, Fernández G et al. Renal disease in metabolic syndrome: The hidden role of intrarenal ischemia. Kidney Int Rep. 2024;9:1419-28.

Kang SY, Lee YH, Jeong SJ, Kim JS, Jeong KH, Hwang HS. How obesity and metabolic syndrome affect cardiovascular events, progression to kidney failure and all-cause mortality in chronic kidney disease. Nephrol Dial Transplant. 2024;39:778-87.

Yang J, Lee HS, Lim CY, et al. Impact of obesity on renal function in elderly Korean adults: a national population-based cohort study. Kidney Research and Clinical Practice. 2024;j.krcp23.187.

Oh H, Quan SA, Jeong J-Y, Jang S-N, Lee JE, Kim D-H. Waist circumference, not body mass index, is associated with renal function decline in Korean population: Hallym aging study. PLoS One. 2013;8:e59071.

Wang L, Du H, Sheng C, Dai H, Chen K. Association between metabolic syndrome and kidney cancer risk: a prospective cohort study. Lipids Health Dis. 2024;17;23(1)142.

Perreault L, Pan Q, Aroda VR, Barrett-Connor E, Dabelea D, Dagogo-Jack S et al. Exploring residual risk for diabetes and microvascular disease in the Diabetes Prevention Program Outcomes Study (DPPOS). Diabet Med. 2017;34:1747-55.

Malheiro LFL, Fernandes MM, Oliveira CA, Barcelos I de S, Fernandes AJV, Silva BS et al. Renoprotective mechanisms of exercise training against acute and chronic renal diseases – A perspective based on experimental studies. Life Sci. 2024;346:122628.

Nataraj M, Maiya GA, Nagaraju SP, Shastry BA, Shivashankara KN, Shetty S et al. Effect of exercise-based rehabilitation on functional capacity and renal function in type 2 diabetes mellitus with nephropathy: a randomized controlled trial. Int Urol Nephrol. 2024;56(8):2671-82.