Chronic Kidney Disease, Metabolic Syndrome and Cardiovascular Risk: Insights and Associated Mechanistic Pathways

Abstract:

This study is a narrative review that aims to address the conceptual, characteristic, pathophysiological, and mechanistic aspects that define the profile of metabolic syndrome and chronic kidney disease. The objective was to investigate current knowledge and elucidate, through discussions on the topic, the main interrelated paths. This review was carried out unsystematically, from March to May 2020, by means of a survey of the literature indexed in the PubMed, Web of Science, and Scopus (Elsevier®) databases. The scientific materials collected showed that the cross-talk between the diseases in question is mainly based on the conditions of resistance to insulin action, endothelial dysfunction, activation pathways of the Renin-Angiotensin-Aldosterone system and adipokine imbalance, also emphasizing the influence of atherosclerotic events in kidney damage. Furthermore, it was reinforced the fact that inflammatory processes play an important role in the worsening and evolution of the clinical condition of patients, especially when they have underlying pathologies chronically treated for subclinical inflammation. It is expected that a greater number of original researches will propose to investigate other possible interactions, with a view to standardized treatment of these diseases or nutritional management.

Influence of Metabolic Syndrome on Factors Associated with Chronic Kidney Disease: A Cross-sectional Study

Background:

Metabolic Syndrome (MetS) is defined by the presence of three or more of the following components: inadequate fasting serum glucose levels and elevated waist circumference, hypertension and dyslipidemia, which represent a potential risk for the development and/or worsening of Chronic Kidney Disease.

Objective:

Based on this, this research aimed to investigate the presence of MetS and its influence on associated factors in patients with Chronic Kidney Disease undergoing hemodialysis.

Methods:

This is an evaluation of a cross-sectional multicenter research project, carried out with 95 patients with Chronic Kidney Disease, seen at outpatient clinics in the state capital Piaui. Anthropometric, biochemical and hemodynamic parameters were determined. The data were analyzed using the Stata® v.12 software (Statacorp, College Station, Texas, USA), adopting a significance level of p < 0,05. The survey received ethical approval (no. 2.527.329).

Results:

It was observed that individuals with elevated BMI, WC, NC, SBP, DBP were more likely to develop MetS, with significant differences (p <0.001). In addition, it was found that serum levels of glucose, insulin, HOMA-IR, TC, LDL, TG and blood pressure were higher in the group with MetS.

Conclusion:

It was concluded that changes in the parameters analyzed in patients with CKD reinforce MetS as a predictive condition for worsening nutritional status and a factor for the progression of kidney disease.

[Do children and adolescents who consume ultra-processed foods have a worse lipid profile? A systematic review]

The increase in the input of ultra-processed ingredients in the food of children and adolescents is related to the development of noncommunicable diseases such as dyslipidemia. The scope of this study was to conduct a systematic review of the literature on the relationship of consumption of ultra-processed foods in the lipid profile of children and adolescents. A search in the PubMed, Scopus, Cochrane and LILACS databases was carried out to locate cross-sectional and longitudinal studies, with or without intervention, in apparently healthy children and/or adolescents, who had the intake of ultra-processed food as an exposure variable and the lipid profile as an outcome. After screening, 14 studies were included, of which nine demonstrated that ultra-processed food consumption was related to increased LDL-c, total cholesterol, triglycerides and a reduction in HDL-c. Three studies found no relationship and two demonstrated that the increased intake of ready-to-eat cereals was related to the decrease in total cholesterol and LDL-c. There was a high consumption of ultra-processed foods and positive relation with blood lipids among children and adolescents, which calls attention to interventions, such as nutritional education, with a view to reducing the intake of these foods.