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The Kidney in Metabolic Syndrome

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Pediatric Nephrology

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Abstract

Increasing epidemiologic evidence shows that obesity and metabolic syndrome (MS) are associated with increased risk of developing chronic kidney disease (CKD). Recent advances in the pathophysiology of obesity-related kidney disease indicate that hemodynamic factors, chronic inflammation, and abnormal lipid metabolism contribute to kidney injury. However, all components of MS, hypertension, atherogenic dyslipidemia, and type 2 diabetes mellitus (T2DM) may induce kidney damage. Children with severe obesity have increased prevalence of early kidney abnormalities, including hyperfiltration, albuminuria, and elevated early urinary biomarkers of kidney injury. Treatment of obesity through lifestyle modification is the mainstream of management of MS. If successful, it is typically associated with the reduction of all other MS cardiometabolic risk components. Pharmacological treatment with angiotensin converting enzyme inhibitors and bariatric surgery in case of severe obesity could provide long-term benefit by slowing the progression to CKD. Novel renoprotective agents, such as GLP-1 analogues and SGLT2 inhibitors need to be evaluated for clinical use in children and adolescents with MS.

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Authors and Affiliations

  1. 1st Pediatric Department, Aristotle University Thessaloniki, Hippocratio Hospital, Thessaloniki, Greece

    Stella Stabouli

  2. Division of Nephrology and Hypertension, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH, USA

    Mark Mitsnefes

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  1. Stella Stabouli
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  2. Mark Mitsnefes
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Correspondence to Mark Mitsnefes .

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Editors and Affiliations

  1. Division of Nephrology, Bambino Gesù Children’s Hospital –, ROMA, Roma, Italy

    Francesco Emma

  2. Division of Nephrology and Hypertension The Heart Institute, University of Cincinnati Cincinnati Children’s Hospital Medical C, Cincinnati, OH, USA

    Stuart Goldstein

  3. Division of Nephrology, All India Institute of Medical Sciences, Ansari Nagar East, Delhi, India

    Arvind Bagga

  4. Division of Pediatric Nephrology, UPMC Children’s Hospital of Pittsburgh, Pittsburgh, PA, USA

    Carlton M. Bates

  5. Renal Unit, Graet Ormond Street Hospital, London, UK

    Rukshana Shroff

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Stabouli, S., Mitsnefes, M. (2021). The Kidney in Metabolic Syndrome. In: Emma, F., Goldstein, S., Bagga, A., Bates, C.M., Shroff, R. (eds) Pediatric Nephrology. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-27843-3_103-1

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  • DOI: https://doi.org/10.1007/978-3-642-27843-3_103-1

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  • Publisher Name: Springer, Berlin, Heidelberg

  • Print ISBN: 978-3-642-27843-3

  • Online ISBN: 978-3-642-27843-3

  • eBook Packages: Springer Reference MedicineReference Module Medicine

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