Metabolic syndrome and risk of development of chronic kidney disease: the Niigata preventive medicine study

Background The metabolic syndrome consists of a cluster of cardiovascular risk factors, many of which have also been implicated in the genesis of chronic kidney disease. We studied the impact of the metabolic syndrome on chronic kidney disease in general population. Methods The Niigata Preventive Medicine Study was community-based prospective observational cohort study based upon the annual health examinations in Japan. We studied the association of the metabolic syndrome with a risk of development of kidney dysfunction and proteinuria in 34 986 participants without baseline kidney disease. Results The metabolic syndrome was present in 3679 subjects (11%). During a follow-up of 5.8 years, kidney dysfunction developed in 184 subjects with metabolic syndrome (5.0%) and 746 subjects without metabolic syndrome (2.4%). The metabolic syndrome was associated with development of kidney dysfunction (hazard ratio [HR], 2.12). All of the metabolic syndrome components were associated with risk of kidney dysfunction. The risk of kidney dysfunction increased across a number of the fulfilled metabolic syndrome components. The association of metabolic syndrome with kidney dysfunction remained significant in subjects without hypertension, diabetes, or cardiovascular disease (HR, 1.99) and in those <= 60 years without hypertension, diabetes, or cardiovascular disease (HR, 2.11). The metabolic syndrome was similarly associated with the development of proteinuria in all subjects (HR, 1.67), in those without hypertension, diabetes, or cardiovascular disease (HR, 1.64) and in those <= 60 years without hypertension, diabetes, or cardiovascular disease (HR, 2.14). Conclusions The metabolic syndrome was associated with kidney disease even in subjects without major classical risk factors for chronic kidney disease. Copyright (C) 2009 John Wiley & Sons, Ltd.