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Clinical Advances in Metabolic Syndrome and Kidney Disease

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A special issue of Journal of Clinical Medicine (ISSN 2077-0383). This special issue belongs to the section "Nephrology & Urology".

Deadline for manuscript submissions: closed (20 March 2023) | Viewed by 8934

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Special Issue Editors

Dr. Amanda Ying Wang

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Guest Editor

The Renal and Metabolic Division, The George Institute for Global Health, University of NSW, Sydney, Australia
Interests: clinical trials; acute kidney injury; chronic kidney disease; dialysis; critical care medicine

Prof. Dr. Li Zuo

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Guest Editor

Department of Nephrology, Peking University People's Hospital, Beijing, China
Interests: chronic kidney disease-mineral bone disease; hemodialysis and peritoneal dialysis; adequacy of blood purification

Special Issue Information

Dear Colleagues,

Metabolic syndrome and chronic kidney disease are two major public health problems. Metabolic syndrome is the constellation of risk factors related to cardiovascular disease, including insulin resistance or hyperglycemia, dyslipidemia, hypertension, and obesity. Metabolic syndrome is associated with an increased risk of cardiovascular disease, stroke, and all-cause mortality in the general population. Chronic kidney disease is increasingly recognized as a significant global public health problem, affecting about 10% of the population worldwide. It causes cardiovascular disease, premature mortality, reduced quality of life, and increased healthcare costs.

The relationship between metabolic syndrome and kidney disease is complex. Metabolic syndrome is an independent risk factor for renal abnormalities. It is associated with microalbuminuria and overt proteinuria, as well as the development and progression of chronic kidney disease. On the other hand, the common risk factors for chronic kidney disease (e.g., diabetes and hypertension) also contribute to metabolic syndrome.

The aim of this Special Issue is to provide updated evidence on the associations of metabolic syndrome and kidney disease, focusing on epidemiological data, pathophysiology, diagnosis, interventional approaches, and prognostic evaluation. Original research articles, systematic reviews, and focused review articles on this topic are welcomed.

Dr. Amanda Ying Wang
Prof. Dr. Li Zuo
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

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Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2600 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

metabolic syndrome
chronic kidney disease
diabetes and hypertension
cardiovascular disease
proteinuria

Published Papers (5 papers)

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Research

13 pages, 5740 KiB

Open AccessArticle

Podocyte Infolding Glomerulopathy: A Case Series Report and Literature Review

by Yunlin Feng, Wei Wang, Yurong Zou, Tingyu Chen, Wei Wang, Guisen Li, Amanda Y. Wang and Ping Zhang

J. Clin. Med. 2023, 12(3), 1088; https://doi.org/10.3390/jcm12031088 - 30 Jan 2023

Cited by 3 | Viewed by 1624

Abstract

Background: Podocyte infolding glomerulopathy (PIG) is a peculiar and very rare manifestation in renal pathology. Its underlying pathogenesis mechanism and clinical characteristics remain unclear due to sparse reports. Objective: To further elucidate the clinical profile of PIG by carefully reporting our four cases and a comprehensive review of cases in the literature. Methods: This study retrospectively reviewed four cases of PIG from 2010 to 2022 in our centre. Clinical and pathological profiles were reported. PIG cases in the literature were searched in the MEDLINE database and analysed together with our cases. Results: Four cases of PIG identified from our centre and 40 cases from the current literature were reported. The pooled analysis of these 44 cases indicated 79.5% (35/44) were females, 93.2% (41/44) were East Asians, and 63.6% (28/44) were reported in Japan. The average age was 42.0 ± 12.5 years old. The average amount of proteinuria at the time of renal biopsy was 3.06 ± 3.2 g/day. The most reported comorbidities were connective tissue diseases, mainly systemic lupus erythematosus, and 20.5% (9/44) of the cases did not have any contaminant disease. Most of the cases (81.8%, 36/44) had been treated with immunosuppressants, of which a combination of corticosteroids and one other type of immunosuppressant was most commonly reported. In addition, 45.4% (20/44) and 34.1% (15/44) of the cases had achieved complete response and partial response, respectively, after treatment. Whole exosome sequencing indicated mutations in the INF2 gene. Conclusions: PIG is a rare condition and seen in relatively younger populations, often associated with connective tissue diseases clinically and one or two other glomerulopathies histologically. The outcomes following immunosuppressive treatment are relatively good. Mutations in INF2 might be involved in the development of PIG; however, the implications of these results need to be investigated. Full article

(This article belongs to the Special Issue Clinical Advances in Metabolic Syndrome and Kidney Disease)

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11 pages, 1315 KiB

Open AccessArticle

Glycated Haemoglobin A1c Variability Score Elicits Kidney Function Decline in Chinese People Living with Type 2 Diabetes

by Yiling Zhou, Hongmei Huang, Xueqin Yan, Simona Hapca, Samira Bell, Furong Qu, Li Liu, Xiangyang Chen, Shengzhao Zhang, Qingyang Shi, Xiaoxi Zeng, Miye Wang, Nan Li, Heyue Du, Wentong Meng, Baihai Su, Haoming Tian, Sheyu Li and on behalf of the WECODe Study Group

J. Clin. Med. 2022, 11(22), 6692; https://doi.org/10.3390/jcm11226692 - 11 Nov 2022

Cited by 4 | Viewed by 1737

Abstract

Our aim was to investigate the association of glycated haemoglobin A1c (HbA1c) variability score (HVS) with estimated glomerular filtration rate (eGFR) slope in Chinese adults living with type 2 diabetes. This cohort study included adults with type 2 diabetes attending outpatient clinics between 2011 and 2019 from a large electronic medical record-based database of diabetes in China (WECODe). We estimated the individual-level visit-to-visit HbA1c variability using HVS, a proportion of changes in HbA1c of ≥0.5% (5.5 mmol/mol). We estimated the odds of people experiencing a rapid eGFR annual decline using a logistic regression and differences across HVS categories in the mean eGFR slope using a mixed-effect model. The analysis involved 2397 individuals and a median follow-up of 4.7 years. Compared with people with HVS ≤ 20%, those with HVS of 60% to 80% had 11% higher odds of experiencing rapid eGFR annual decline, with an extra eGFR decline of 0.93 mL/min/1.73 m² per year on average; those with HVS > 80% showed 26% higher odds of experiencing a rapid eGFR annual decline, with an extra decline of 1.83 mL/min/1.73 m² per year on average. Chinese adults with type 2 diabetes and HVS > 60% could experience a more rapid eGFR decline. Full article

(This article belongs to the Special Issue Clinical Advances in Metabolic Syndrome and Kidney Disease)

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14 pages, 2583 KiB

Open AccessArticle

The Reciprocal Relationship between Osteoporosis and Renal Stones

by So Young Kim, Juyong Chung, Doo Sik Park, Dae Myoung Yoo, Woo Jin Bang and Hyo Geun Choi

J. Clin. Med. 2022, 11(22), 6614; https://doi.org/10.3390/jcm11226614 - 08 Nov 2022

Cited by 3 | Viewed by 1427

Abstract

Previous studies have proposed an association between osteoporosis and renal stones. The current analyses intended to investigate the bidirectional relationship between osteoporosis and renal stones. The ≥40-year-old population in the National Health Insurance Service-Health Screening cohort (2002–2015) was analyzed. In study I, 67,811 patients with osteoporosis and 67,811 control I participants were matched. The hazard ratio (HR) of osteoporosis for renal stones was calculated using stratified Cox proportional hazard models. In study II, 25,261 patients with renal stones and 101,044 control II participants were matched. The HR of renal stones for osteoporosis was estimated using stratified Cox proportional hazard models. In study I, 3.4% (2276/67,811) of osteoporosis patients and 2.5% (1696/67,811) of control I participants had renal stones. Osteoporosis patients had a 1.36 times higher HR for renal stones than control I participants (95% confidence intervals [CI] = 1.28–1.45). In study II, 9.2% (2319/25,261) of renal stone patients and 7.6% (7658/101,044) of control II participants had osteoporosis. Renal stone patients had a 1.26 times higher HR for osteoporosis than control II participants (95% CI = 1.21–1.32). Adults with osteoporosis had a higher risk of renal stones. Moreover, adults with renal stones had a higher risk of osteoporosis. Full article

(This article belongs to the Special Issue Clinical Advances in Metabolic Syndrome and Kidney Disease)

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14 pages, 1032 KiB

Open AccessArticle

Adherence to the Mediterranean Diet Is Associated with a More Favorable Left Ventricular Geometry in Patients with End-Stage Kidney Disease

by Dimitra Bacharaki, Ioannis Petrakis, Periklis Kyriazis, Anastasia Markaki, Christos Pleros, Georgios Tsirpanlis, Marios Theodoridis, Olga Balafa, Anastasia Georgoulidou, Eleni Drosataki and Kostas Stylianou

J. Clin. Med. 2022, 11(19), 5746; https://doi.org/10.3390/jcm11195746 - 28 Sep 2022

Cited by 3 | Viewed by 1599

Abstract

Introduction. The aim of the study was to examine the impact of adherence to a Mediterranean-style diet (MD) on left ventricular hypertrophy (LVH) and cardiac geometry in chronic kidney disease patients on dialysis (CKD-5D), given the high prevalence of cardiovascular morbidity in this population. Methods. n = 127 (77 men and 50 women) CKD-5D patients (69 on hemodialysis and 58 on peritoneal dialysis) with a mean age of 62 ± 15 years were studied. An MD adherence score (MDS) (range 0–55, 55 representing maximal adherence) was estimated with a validated method. Echocardiographic LVH was defined by LV mass index (LVMI) > 95 g/m² in women and >115 g/m² in men. Based on LVMI and relative wall thickness (RWT), four LV geometric patterns were defined: normal (normal LVMI and RWT), concentric remodeling (normal LVMI and increased RWT > 0.42), eccentric LVH (increased LVMI and normal RWT), and concentric LVH (increased LVMI and RWT). Results. Patients with LVH (n = 81) as compared to patients with no LVH (n = 46) were older in age (66 ± 13 vs. 55 ± 16 years; p < 0.001) had lower MDS (24 ± 2.7 vs. 25 ± 4.3; p < 0.05) and higher malnutrition-inflammation score (5.0 ± 2.7 vs. 3.9 ± 1.9; p < 0.05), body mass index (27.5 ± 4.9 vs. 24.1 ± 3.5 kg/m²; p < 0.001), prevalence of diabetes (79% vs. 20%; p < 0.05), coronary artery disease (78% vs. 20%; p < 0.05) and peripheral vascular disease (78% vs. 20%; p < 0.01). In a multivariate logistic regression analysis adjusted for all factors mentioned above, each 1-point greater MDS was associated with 18% lower odds of having LVH (OR = 0.82, 95% CI: 0.69–0.98; p < 0.05). MDS was inversely related to LVMI (r = −0.273; p = 0.02), and in a multiple linear regression model (where LVMI was analyzed as a continuous variable), MDS emerged as a significant (Β = −2.217; p < 0.01) independent predictor of LVH. Considering LV geometry, there was a progressive decrease in MDS from the normal group (25.0 ± 3.7) to concentric remodeling (25.8 ± 3.0), eccentric (24.0 ± 2.8), and then concentric (23.6 ± 2.7) group (p < 0.05 for the trend). Conclusions. The greater adherence to an MD is associated with lesser LVH, an important cardiovascular disease risk factor; MD preserves normal cardiac geometry and may confer protection against future cardiac dysfunction in dialysis patients. Full article

(This article belongs to the Special Issue Clinical Advances in Metabolic Syndrome and Kidney Disease)

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18 pages, 2657 KiB

Open AccessArticle

Th17/Regulatory T-Cell Imbalance and Acute Kidney Injury in Patients with Sepsis

by Xiao Zhou, Jingyi Yao, Jin Lin, Jingfeng Liu, Lei Dong and Meili Duan

J. Clin. Med. 2022, 11(14), 4027; https://doi.org/10.3390/jcm11144027 - 12 Jul 2022

Cited by 8 | Viewed by 1562

Abstract

To analyze the predictive value of the Th17/Treg ratio for renal injury in sepsis patients, a prospective observational study was conducted. Adult patients with sepsis were enrolled and divided into a sepsis-induced acute kidney injury (SAKI) group and a sepsis-without-AKI group. Logistic regression was used to analyze the independent predictors of SAKI, and the ROC curve was plotted to evaluate the predictive value of the Th17/Treg ratio for renal injury in patients with sepsis. A total of 124 patients were enrolled in this study, including 60 cases (48.39%) of SAKI. Patients who developed sepsis-induced acute kidney injury had a higher Th17/Treg ratio level compared to patients without it (0.11 [0.07, 0.28] versus 0.06 [0.05, 0.16], p < 0.05, respectively. The area under the receiver operating characteristic curve of the Th17/Treg ratio to predict sepsis-induced acute kidney injury was 0.669 (95% CI 0.574–0.763, p < 0.05). The Th17/Treg ratio was associated with SAKI (OR 1.15, 95%CI [1.06–1.24], p < 0.05, non-adjusted and R 1.12, 95%CI [1.00–1.25], p < 0.05, adjusted). The use of the Th17/Treg ratio improved the prediction performance of the prediction model of NAGL. The median Th17/Treg ratio significantly increased with the stratified KDIGO stage (p < 0.05). Th17/Treg imbalance was associated with occurrence of acute kidney injury and AKI severity in patients with sepsis. The Th17/Treg ratio could be a potential predictive marker of sepsis-induced acute kidney injury. Full article

(This article belongs to the Special Issue Clinical Advances in Metabolic Syndrome and Kidney Disease)

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