Metabolic syndrome and kidney diseases

Metabolic syndrome (MetS) was first described in the late 1980s and is defined by the simultaneous presence of at least three of the following five components: obesity, dyslipoproteinemia, glucose intolerance or diabetes mellitus type 2 and arterial hypertension. Due to the worldwide improvement of living conditions associated with an increase in diseases of civilization, such as obesity and hypertension, an increasing incidence of MetS has been observed for decades. The MetS is a cluster of cardiovascular risk factors that negatively influence the development and progression of chronic renal failure. Due to numerous pathophysiological changes, the metabolism is in a proinflammatory steady state and under increasing oxidative stress at the cellular level. The kidneys, as the organ with a central function to maintain body homeostasis, is affected by the physiological changes in the context of a MetS. A premature development of chronic renal failure or acceleration and progression of this is associated with the individual components of MetS. Bioptically, obesity-associated changes, such as obesity-related glomerulopathy (ORG), defined as glomerulomegaly with or without focal segmental glomerulosclerosis, can be detected. Treatment of MetS is primarily guided by professional society guidelines for each of the above components, which must be elicited individually for each patient. The understanding of this complex entity, taking the pathophysiology and the associated impairment of the interplay of almost all organ systems into account, has grown rapidly in recent years, especially as these remain largely unexplained.