Clinicopathological Analysis of26Cases with Renal Damage Associated with Metabolic Syndrome
|School||Chongqing Medical University|
|Keywords||clinical characteristics Metabolic syndrome renaldamage renal pathology|
OBJECTIVE: To investigate the clinical characteristics, kidneypathology, diagnosis, treatment and prognosis of renal damage associatedwith Metabolic syndrome (MetS).METHODS: The clinical data of26patients with MetS was collected,and renal pathology of26patients of was retrospectively analyzed.RESULTS: The average onset age of renal damage in these26patients with MetS was (44±8.65) years old. The manifestation of renaldamage was proteinuria. GFR increased in the early stage of disease anddecreased later. The major character of renal pathology showed mesangialproliferative nephritis. Twenty-four patients showed focal segmental todiffuse mesangial proliferation, and16patients showed focal segmentalor diffuse glomerulosclerosis. Seventeen patients showedglomerulocapillary damage, focal segmental occlusion, ischemia, capillaryproliferation, dome congestion, and so on. Twenty-two patients showsclerosis of renal arterioles. All patients showed mild renal tubular atrophyand interstitial fibrosis, glomerulosclerosis and renal atherosclerosis was particularly obvious in MetS patients with hypertension. Twelve of26patients with hematuria were diagnosed with IgA nephropathy by renalimmunohistochemisty staining. All patients were treated with both ACEI/ARB+CCB to control hypertension or to reduce proteinuria. Othertreatments including body weight control, insulin sensitizers, andsulfonylurea drugs or glucosidase inhibitor to control plasma glucose, andstatins or fibrates drug to control hyperlipidemia. Proteinuria shaded afterthe treatments in13patients.Conclusion: Clinical manifestations of MetS-associated renaldamage were proteinuria, increased glomerular filtration rate in the earlystages of disease and decreased finally. The renal pathological changes ofMetS are diffuse mesangial proliferation, focal segmentalglomerulosclerosis, tubular atrophy, and interstitial fibrosis. Hypertensionmay be an important risk factor for MetS-associated renal damage.Hematuria is often the predominant feature of IgA nephropathy patientsaccompanied with MetS. Renal damage may be improved by control ofvarious risk factors of MetS.