The Acute Renal Involvement in the Metabolic Syndrome

The Metabolic Syndrome (MS) encompasses many metabolic abnormalities and the insulin resistance is the most significant denominator. The chronic kidney disease (CKD) is an emerging health problem but only few patients will reach the end stage renal disease. It exists an increasing strong association between MS and CKD but up to now the link between MS and CKD is unclear and there are few studies regarding the renal histology in MS. We describe an acute tubulointerstitial nephritis case, due to both infective and pharmacological aetiology, overlapping relevant histological changes (FSG, hyaline arteriosclerosis) in a patient with MS and previously normal renal function. Despite the severe vascular finding (elevated renal arterial resistive index), the patient recovered a normal renal function. We reviewed the kidney pathological studies in Metabolic Syndrome and we analyzed the principal renal histological pictures: glomerulomegaly, segmental glomerulosclerosis, obesity-related glomerulopathy. Despite the strong association, the renal involvement in MS has not been proven. A greater knowledge of the combination of histological renal changes in MS can help in the understanding of pathophysiological mechanisms of MS.

Keywords: Acute kidney injury, Metabolic Syndrome, Obesity.