N.O. Pertseva, M.K. Rokutova

Assessment of renal function in patients with metabolic syndrome

In the article the results of evaluation the kidney function and their relationship with the components of metabolic syndrome (MS) in young patients are presented. We examined 61 patients from 18 to 40 years (mean age - 28,0±1,0 years) with abdominal obesity (AO), I-III degree (according to the classification IDF, 2005) without diabetes mellitus (DM) 1 or type 2 diabetes. Among them - 29 men (47,5%), women - 32 (52,5%). Patients were divided into 2 subgroups based on the presence of hypertension (AH), I-II stage, degree 1: Ia - with abdominal obesity without hypertension (n = 31) and Ib - those with abdominal obesity and hypertension, I-II stage 1 degree (n = 30). Among patients MS observed in 34,4% of patients with abdominal obesity and hypertension; in 19,7% of patients - with abdominal obesity without hypertension. The study revealed the presence of glomerular hyperfiltration in 47 (77,0%) patients with abdominal obesity regardless of the presence hypertension; MAU - only in 7 (11,5%) patients; b2-microglobulinuria- in almost all (93,4%) patients. The total incidence of elevated levels of urinary albumin / creatinine urine ratio is in 8 (13,1%) patients, increasing the ratio of b2-microglobulin urine / urine creatinine - in majority (90,2%) cases. In analysis observed a correlation between the quantity of MS components and levels of eGFR (r = 0,54, p <0,001), urine albumin (r = 0,59, p <0,001), urine b2-microglobulin (r = 0, 53, p <0,001) and the ratio of albumin urine / urine creatinine (r = 0,47, p <0,001) and b2-microglobulin urine / urine creatinine (r = 0,45, p <0.001). Consequently, in young patients with metabolic syndrome most informative markers of early kidney damage is hyperfiltration and b2-microglobulinuria. MAU has a lower diagnostic value. With the gradual joining the components of metabolic syndrome observed aggravation of kidney function in patients with metabolic syndrome. A high percentage detection of patients with metabolic syndrome demonstrates the attention to young patients with abdominal obesity as a group at high risk of cardiovascular and renal complications, considering relationships between its components and metabolic changes during diagnosis and treatment.