Association of changes in metabolic syndrome with new-onset and progression of chronic kidney disease

Background: Metabolic syndrome (MetS) is an independent risk factor for new-onset and progression of chronic kidney disease (CKD). However, whether changes in MetS are associated with the new-onset CKD and its progression remains unknown.

Methods: A total of 36,571 participants from the Kailuan Study were enrolled in this study, including 27,072 without CKD and 9499 with CKD at baseline. According to the changes of MetS, 4 groups were divided as follows: MetS-free group, MetS-recovered group, MetS-developed group, and MetS-persistent group. Cox regression models were used to explore the association of changes in MetS with new-onset and progression of CKD.

Results: During a median follow-up of 8.38 years, 3313 cases of new-onset CKD were identified in participants without CKD. Compared with the MetS-free group, the hazard ratio (HR) and 95% confidence interval (95% CI) for new-onset CKD in the MetS-recovered, MetS-developed and MetS-persistent groups was 1.34 (1.18-1.53), 1.46 (1.30-1.63) and 1.85 (1.69-2.02), respectively. Among 9499 participants with CKD, during a median follow-up of 8.18 years, a total of 2305 experienced CKD progression. Compared with the MetS-free group, the HR (95% CI) for CKD progression in each group were 1.05 (0.91-1.22), 1.34 (1.17-1.55) and 1.65 (1.49-1.83), respectively. Furthermore, the association between changes in MetS and new-onset CKD was stronger in younger and middle-aged participants (≤60 years old) compared with older participants.

Conclusions: Developed MetS and persistent MetS were both risk factors for the new-onset and progression of CKD. Even with recovery from MetS, an association of MetS with kidney damage remained.