Insulin Resistance and the Metabolic Syndrome in Kidney Disease (e.g., the Cardiorenal Metabolic Syndrome)

The cardiorenal metabolic syndrome is a collection of metabolic risk factors driven by obesity and insulin resistance that convey an increased risk for cardiovascular and kidney disease. In this context, there has been increasing interest in the impact of insulin resistance and the compensatory hyperinsulinemia on kidney disease, independent to that of the contribution of overt diabetes to the development of kidney disease. It is unknown whether there is a direct causal relationship between insulin resistance and progressive kidney disease or just the presence of known risk factors for the initiation and progression of chronic kidney disease (CKD) (i.e., hypertension and obesity), yet growing evidence supports that obesity and insulin resistance directly contribute to CKD.