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Abstract
Metabolic syndrome (MS) is one of the important factors in the development of type 2 diabetes mellitus (T2DM) in men. The multifactorial nature of the pathogenetic mechanisms underlying the formation of MS and its subsequent progression, and possible development of T2DM is one of the important mechanisms which contribute to kidney dysfunction. The leading role in the development of chronic kidney disease in men with MS is played by the severity of insulin resistance, the presence of obesity, the functional state of the sympathoadrenal system, arterial hypertension, sex hormone levels, and the state of lipid metabolism. Kidney pathology is diagnosed in approximately 40% of patients with T2DM and probably has a significant impact on the development and progression of cardiovascular pathology. The latter diseases are generally recognized factors leading to an increase in the mortality rate among men with T2DM. It is believed that one of the common factors in the development of MS, T2DM and chronic kidney disease is age. However, the latter is not a proven factor in the development of one of the main components of MS — obesity. There is no doubt that obesity itself affects kidney function and the risk of chronic kidney disease. The relationship between obesity and chronic kidney disease is not always explained by the relationship between obesity and T2DM or arterial hypertension, respectively. Obesity is associated with increased glomerular filtration rate and renal blood flow, as well as the development of focal segmental glomerulosclerosis. In the pathogenesis of the development of renal pathology in MS, it is characteristic that insulin resistance is associated with increased tubular sodium reabsorption. This review focuses on the epidemiology and mechanisms associated with renal vascular injury. However, it should be remembered that the prevention and treatment of kidney disease requires a multifactorial approach. Chronic kidney disease in men with T2DM and MS requires a multidisciplinary approach involving specialists from different specialties (in addition to specialized endocrinologists and nephrologists) in order to prevent the formation of kidney pathology in the early stages of the development of the underlying disease.
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