Clinical nephrologyClinical nephrologyКлиническая нефрология2075-35942414-9322Bionika Media70406510.18565/nephrology.2026.1.81-87Literature ReviewsОбзоры литературыReview ArticleMetabolic syndrome. Focus on the kidneysМетаболический синдром. Акцент на почкиhttps://orcid.org/0000-0001-5070-5955MikhailovaLarisa V.МихайловаЛариса Викторовна
Russian Federation

Cand.Sci. (Med.), Associate Professor, Department of Therapy, Institute of Medicine and Life Sciences (MEDBIO)

к.м.н., доцент кафедры терапии Института медицины и наук о жизни (МЕДБИО)

mihalysa@mail.ruhttps://orcid.org/0000-0003-1743-4713TynterovaAnastasia М.ТынтероваАнастасия Михайловна
Russian Federation

Dr.Sci. (Med.), Senior Researcher. Baltic Center for Artificial Intelligence and Neurotechnology

д.м.н., старший научный сотрудник Балтийского центра нейротехнологий и искусственного интеллекта

antynterova@mail.ruhttps://orcid.org/0000-0002-2503-9580RafalskiyVladimir V.РафальскийВладимир Витальевич
Russian Federation

Dr.Sci. (Med.), Professor, Head of the Department of General and Clinical Pharmacology, Institute of Medicine and Life Sciences (MEDBIO)

д.м.н., профессор, заведующий кафедрой Общей и клинической фармакологии Института медицины и наук о жизни (МЕДБИО)

v.rafalskiy@mail.ruhttps://orcid.org/0000-0002-2379-6764KryukovaNadezhda O.КрюковаНадежда Олеговна
Russian Federation

Cand.Sci.(Med.), Associate Professor, Department of General and Clinical Pharmacology, Institute of Medicine and Life Sciences (MEDBIO)

к.м.н., доцент кафедры Общей и клинической фармакологии Института медицины и наук о жизни (МЕДБИО)

krukovano@yandex.ruhttps://orcid.org/0009-0000-1864-2448FilimonkinaYulia A.ФилимонкинаЮлия Александровна
Russian Federation

Teaching Assistant, Department of Therapy, Institute of Medicine and Life Sciences (MEDBIO)

ассистент кафедры терапии Института медицины и наук о жизни (МЕДБИО)

j.filimonkina@mail.ruhttps://orcid.org/0009-0006-6398-9890VakhninaKsenia V.ВахнинаКсения Владимировна
Russian Federation

6-year Student student of the Higher School of Medicine, Institute of Medicine and Life Sciences (MEDBIO)

студентка 6 курса Высшей школы медицины Института медицины и наук о жизни (МЕДБИО)

kseniya20024@gmail.comImmanuel Kant Baltic Federal UniversityБалтийский федеральный университет им. Иммануила Канта1103202618181871003202610032026Copyright ©; 2026, Bionika MediaCopyright ©; 2026, ООО «Бионика Медиа»2026Bionika MediaООО «Бионика Медиа»https://journals.eco-vector.com/2075-3594/article/view/704065

This article examines the evolution of the concept of metabolic syndrome (MS) and its close association with the development of chronic kidney disease (CKD). MS is a cluster of disorders including abdominal obesity, insulin resistance, dyslipidemia, and arterial hypertension, which significantly increases the risk of developing cardiovascular complications, type 2 diabetes mellitus, and CKD. The incidence of MS and CKD continues to rise worldwide, resulting in high mortality, primarily from cardiovascular complications. The authors note the growing need for early detection and correction of metabolic risk factors, the need to develop methods for preclinical diagnosis of CKD in patients with MS, and a multidisciplinary approach to patient management. Key objectives include identifying early biomarkers of kidney damage and the widespread implementation of preventive strategies to reduce the risk of cardiovascular and renal complications in patients with MS.

Статья посвящена эволюции концепции метаболического синдрома (МС) и его тесной связи с развитием хронической болезни почек (ХБП). МС представляет собой совокупность нарушений, включающих в себя абдоминальное ожирение, инсулинорезистентность, дислипидемию и артериальную гипертензию, которая значительно повышает риск развития сердечно-сосудистых осложнений, сахарного диабета 2-го типа и ХБП. Заболеваемость МС и ХБП продолжает расти во всем мире, что обусловливает высокую смертность, прежде всего от сердечно-сосудистых осложнений. Авторы отмечают растущую необходимость раннего выявления и коррекции метаболических факторов риска, необходимости поиска методов доклинической диагностики ХБП при МС и междисциплинарного подхода к ведению пациентов. Ключевыми задачами являются поиск ранних биомаркеров поражения почек и широкое внедрение профилактических стратегий для снижения риска сердечно-сосудистых и почечных осложнений у больных МС.

metabolic syndromechronic kidney diseasecardiovascular diseaseobesitydyslipidemiainsulin resistancearterial hypertensionметаболический синдромхроническая болезнь почексердечно-сосудистые заболеванияожирениедислипидемияинсулинорезистентностьартериальная гипертензияReaven G.M. Banting lecture 1988. Role of insulin resistance in human disease. Diabetes. 1988;37(12):1595–607. Doi: 10.2337/diab.37.12.1595).Himsworth H.P. The mechanism of diabetes mellitus. Lancet. 1939;234(6047):171–6. Doi.org/10.1016/S0140-6736(00)61945-1.Yalow R.S., Berson S.A. Immunoassay of endogenous plasma insulin in man. J. Clin. Invest. 1960;39(7):1157–75. Doi: 10.1172/JCI104130.Haffner S.M., Stern M.P., Mitchell B.D. et al. Incidence of type II diabetes in Mexican Americans predicted by fasting insulin and glucose levels, obesity, and body-fat distribution. Diabetes. 1990;39(3):283–8. Doi: 10.2337/diab.39.3.283.Sicree R.A., Zimmet P.Z., King H.O., Coventry J.S. Plasma insulin response among Nauruans. Prediction of deterioration in glucose tolerance over 6 yr. Diabetes. 1987;36(2):179–86. Doi: 10.2337/diab.36.2.179.Ferrannini E., Buzzigoli G., Bonadonna R. et al. Insulin resistance in essential hypertension. N. Engl. J. Med. 1987;317(6):350–7. Doi: 10.1056/NEJM198708063170605.Zavaroni I., Bonora E., Pagliara M. et al. Risk factors for coronary artery disease in healthy persons with hyperinsulinemia and normal glucose tolerance. N. Engl. J. Med. 1989;320(11):702–6. Doi: 10.1056/NEJM198903163201105.Kaplan N.M. The deadly quartet. Upper-body obesity, glucose intolerance, hypertriglyceridemia, and hypertension. Arch. Intern. Med. 1989;149(7):1514–20. Doi: 10.1001/archinte.149.7.1514.Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults. Executive Summary of The Third Report of The National Cholesterol Education Program (NCEP) Expert Panel on Detection, Evaluation, And Treatment of High Blood Cholesterol In Adults (Adult Treatment Panel III). JAMA. 2001;285(19):2486–97. Doi: 10.1001/jama.285.19.2486.Wilson P.W., D’Agostino R.B., Parise H., Sullivan L. et al. Metabolic syndrome as a precursor of cardiovascular disease and type 2 diabetes mellitus. Circulation. 2005;112:3066–72. Doi: 10.1161/CIRCULATIONAHA.105.539528.Ford E.S. Risks for all-cause mortality, cardiovascular disease, and diabetes associated with the metabolic syndrome: A summary of the evidence. Diab. Care. 2005;28:1769–78. Doi: 10.2337/diacare.28.7.1769.Mottillo S., Filion K.B., Genest J. et al. The metabolic syndrome and cardiovascular risk: A systematic review and meta-analysis. J. Am. Coll. Cardiol. 2010;56:1113–32. Doi: 10.1016/j.jacc.2010.05.034.Ford E.S., Li C., Sattar N. Metabolic syndrome and incident diabetes: Current state of the evidence. Diab. Care. 2008;31:1898–904. Doi: 10.2337/dc08-0423.Alberti K.G., Eckel R.H., Grundy S.M. et al. Harmonizing the metabolic syndrome: a joint interim statement of the International Diabetes Federation Task Force on Epidemiology and Prevention; National Heart, Lung, and Blood Institute; American Heart Association; World Heart Federation; International Atherosclerosis Society; and International Association for the Study of Obesity. Circulation. 2009;120(16):1640–5. Doi: 10.1161/CIRCULATIONAHA.109.192644.Диагностика и лечение метаболического синдрома Российские рекомендации. Кардиоваскулярная терапия и профилактика. 2007:3–28. [Diagnostics and treatment of metabolic syndrome Russian recommendations. Cardiovasc. Ther. Prevent. 2007:3–28 (In Russ.)]. https://doi.org/10.15829/1728-8800-2007-0-3-28.Мычка В.Б., Жернакова Ю.В., Чазова И.Е. Рекомендации экспертов Всероссийского научного общества кардиологов по диагностике и лечению метаболического синдрома (второй пересмотр). Доктор.Ру. 2010;3. [Michka V.B., Zhernakova Yu.V., Chazova I.E. Recommendations of experts of the All-Russian Scientific Society of Cardiologists on the diagnosis and treatment of metabolic syndrome (second revision). Doctor.Ru. 2010;3 (In Russ.)].Levey A.S., Beto J.A., Coronado B.E. et al. Controlling the epidemic of cardiovascular disease in chronic renal disease: what do we know? What do we need to learn? Where do we go from here? National Kidney Foundation Task Force on Cardiovascular Disease. Am. J. Kidney Dis. 1998;32(5):853–906. Doi: 10.1016/s0272-6386(98)70145-3.Levey A.S., Coresh J., Balk E. et al. National Kidney Foundation practice guidelines for chronic kidney disease: evaluation, classification, and stratification. Ann. Intern. Med. 2003;139(2):137–47. Doi: 10.7326/0003-4819-139-2-200307150-00013.National Kidney Foundation. K/DOQI clinical practice guidelines for managing dyslipidemias in chronic kidney disease. Am. J. Kidney Dis. 2003;41:S1–91.Marín R., Alvarez-Navascués R. Novedades en la Guía Europea de Hipertensión 2007 [Novelties in the European Hypertension Guide 2007. European Society of Cardiology. Eur. Soc. Hypertens. Nefrologia. 2008; 28(Suppl. 5):121–9.Ronco C., Haapio M., House A.A. et al. Cardiorenal syndrome. J. Am. Coll. Cardiol. 2008;52(19):1527–39. Doi: 10.1016/j.jacc.2008.07.051.Ke C., Liang J., Liu M. et al. Burden of chronic kidney disease and its risk-attributable burden in 137 low-and middle-income countries, 1990-2019: results from the global burden of disease study 2019. BMC. Nephrol. 2022;23(1):17. Published 2022 Jan 5. Doi:10.1186/s12882-021-02597-3.Ndumele C.E., Rangaswami J., Chow S.L. et al. American Heart Association. Cardiovascular-Kidney-Metabolic Health: A Presidential Advisory From the American Heart Association. Circulation. 2023 Nov 14;148(20):1606-1635. doi: 10.1161/CIR.0000000000001184. Epub 2023 Oct 9. Erratum in: Circulation. 2024;149(13):e1023. Doi: 10.1161/CIR.0000000000001241. [PMID: 37807924].Ndumele C.E., Rangaswami J., Chow S.L. et al. Cardiovascular-Kidney-Metabolic Health: A Presidential Advisory from the American Heart Association. Circulation. 2023;148(20):1606–35. Doi: 10.1161/CIR.0000000000001184.Saxton S.N., Clark B.J., Withers S.B. et al. Mechanistic Links Between Obesity, Diabetes, and Blood Pressure: Role of Perivascular Adipose Tissue. Physiol. Rev. 2019;99(4):1701–63. Doi: 10.1152/physrev.00034.2018. [PMID: 31339053].Epstein M. Aldosterone and Mineralocorticoid receptor signaling as determinants of cardiovascular and renal injury: from Hans Selye to the present. Am. J. Nephrol. 2021;52:209–16. Doi: 10.1159/000515622.Tuttle K.R., Bruton J.L., Perusek M.C. et al. Effect of strict glycemic control on renal hemodynamic response to amino acids and renal enlargement in insulin-dependent diabetes mellitus. N. Engl. J. Med. 1991;324:1626–32. Doi: 10.1056/NEJM199106063242304.Tuttle K.R., Bruton J.L. Effect of insulin therapy on renal hemodynamic response to amino acids and renal hypertrophy in non-insulin-dependent diabetes. Kidney Int. 1992;42:167–73. Doi: 10.1038/ki.1992.274.Kanbay M., Copur S., Bakir C.N. et al. Glomerular hyperfiltration as a therapeutic target for CKD. Nephrol. Dial. Transplant. 2024;39:1228–38. Doi: 10.1093/ndt/gfae027.Chung E.Y.M., Badve S.V., Heerspink H.J.L. et al. Endothelin receptor antagonists in kidney protection for diabetic kidney disease and beyond? Nephrology. 2023;28:97–108. Doi: 10.1111/nep.14130.Tuttle K.R. Back to the future: glomerular hyperfiltration and the diabetic kidney. Diabetes. 2017;66:14–6. Doi: 10.2337/dbi16-0056.Alicic R.Z., Neumiller J.J., Johnson E.J., et al. Sodium-glucose cotransporter 2 inhibition and diabetic kidney disease. Diabetes. 2019;68:248–57. Doi: 10.2337/dbi18-0007.Tuttle K.R., Puhlman M.E., Cooney S.K., Short R.A. Effects of amino acids and glucagon on renal hemodynamics in type 1 diabetes. Am. J. Physiol. Renal. Physiol. 2002;282:F103–12. Doi: 10.1152/ajprenal.00155.2001.Alicic R.Z., Neumiller J.J., Tuttle K.R. Combination therapy: an upcoming paradigm to improve kidney and cardiovascular outcomes in chronic kidney disease. Nephrol. Dial. Transplant. 2025;40(Suppl._1):i3–17. Doi: 10.1093/ndt/gfae212.Jamali Z., Ayoobi F., Jalali Z. et al. Metabolic syndrome: a population-based study of prevalence and risk factors. Sci. Rep. 2024;14(1):3987. Doi: 10.1038/s41598-024-54367-4. [PMID: 38368464, PMCID: PMC10874377].Tao Z., Zuo P., Ma G. Association of weight-adjusted waist index with cardiovascular disease and mortality among metabolic syndrome population. Sci. Rep. 2024;14(1):18684. Doi: 10.1038/s41598-024-69486-1. [PMID: 39134613, PMCID: PMC11319818].Adjei N.K., Samkange-Zeeb .F, Boakye D. et al. Ethnic differences in metabolic syndrome in high-income countries: A systematic review and meta-analysis. Rev. Endocr. Metab. Disord. 2024 Aug;25(4):727-750. doi: 10.1007/s11154-024-09879-9. [Epub 2024 Apr 10, PMID: 38598068, PMCID: PMC11294386].Ma K., Liu H., Guo L. et al. Comparison of metabolic syndrome prevalence and characteristics using five different definitions in China: a population-based retrospective study. Front. Public Health. 2024;12:1333910. Doi: 10.3389/fpubh.2024.1333910. [PMID: 38439751, PMCID: PMC10909998].Jager K.J., Kovesdy C., Langham R. et al. A single number for advocacy and communication-worldwide more than 850 million individuals have kidney diseases. Nephrol. Dial. Transplant. 2019;34(11):1803–5. Doi: 10.1093/ndt/gfz174.Ke C., Liang J., Liu M. et al. Burden of chronic kidney disease and its risk-attributable burden in 137 low-and middle-income countries, 1990–2019: results from the global burden of disease study 2019. BMC. Nephrol. 2022;23(1):17. Published 2022 Jan 5. Doi: 10.1186/ s12882-021-02597-3.Foreman K.J., Marquez N., Dolgert A., et al. Forecasting life expectancy, years of life lost, and all-cause and cause-specific mortality for 250 causes of death: reference and alternative scenarios for 2016-40 for 195 countries and territories. Lancet. 2018;392(10159):2052–90. Doi: 10.1016/ S0140-6736(18)31694-5.Ortiz A., Arreola Guerra J.M., Chan J.C.N. et al. Preventing chronic kidney disease and maintaining kidney health: conclusions from a Kidney Disease: Improving Global Outcomes (KDIGO) Controversies Conference. Kidney Int. Published online June 18, 2025. Doi: 10.1016/ j.kint.2025.04.005.Ix J.H., Shlipak M.G. The Promise of Tubule Biomarkers in Kidney Disease: A Review. Am. J. Kidney Dis. 2021;78(5):719–27. Doi: 10.1053/ j.ajkd.2021.03.026.Pontillo C., Mischak H. Urinary peptide-based classifier CKD273: towards clinical application in chronic kidney disease. Clin. Kidney J. 2017;10(2): 192–201. Doi: 10.1093/ckj/sfx002.Tofte N., Lindhardt M., Adamova K. et al. Early detection of diabetic kidney disease by urinary proteomics and subsequent intervention with spironolactone to delay progression (PRIORITY): a prospective observational study and embedded randomised placebo-controlled trial. Lancet. Diab. Endocrinol. 2020;8(4):301–12. Doi: 10.1016/S2213-8587(20)30026-7.Castillo-Rodriguez E., Fernandez-Prado R., Martin-Cleary C. et al. Kidney Injury Marker 1 and Neutrophil Gelatinase-Associated Lipocalin in Chronic Kidney Disease. Nephron. 2017;136(4):263–7. Doi: 10.1159/ 000447649.National Kidney Foundation. Take a minute for your kidneys. https:// www.kidney.org/kidney-quiz.Ortiz A., Arreola Guerra J.M., Chan J.C.N. et al. Preventing chronic kidney disease and maintaining kidney health: conclusions from a Kidney Disease: Improving Global Outcomes (KDIGO) Controversies Conference. Kidney Int. Published online June 18, 2025. Doi: 10.1016/ j.kint.2025.04.005.Kidney Disease: Improving Global Outcomes (KDIGO) CKD Work Group. KDIGO 2024 Clinical Practice Guideline for the Evaluation and Management of Chronic Kidney Disease. Kidney Int. 2024;105(4S):S117–314. Doi: 10.1016/j.kint.2023.10.018.Visseren F.L.J., Mach F., Smulders Y.M. et al. 2021 ESC Guidelines on cardiovascular disease prevention in clinical practice. Eur. Heart J. 2021;42(34):3227–337. Doi: 10.1093/eurheartj/ehab484.