Biochemical Predictors of Renal Dysfunction and Evidence-Based Prevention Strategies for Chronic Kidney Disease in Patients with Metabolic Syndrome: Findings from a Tertiary Care Hospital in Central India

Abstract

Background: Metabolic syndrome (MetS) drives progressive renal injury through overlapping mechanisms of insulin resistance, oxidative stress, and haemodynamic alterations. While global data link MetS to chronic kidney disease (CKD), biochemical characterisation of predictors and evidence-based prevention strategies tailored to Indian populations remain underexplored.

Objectives: To identify biochemical predictors of renal dysfunction in MetS patients, evaluate lipid and glucose profiles in relation to eGFR, characterise the CKD burden across MetS component clustering, and synthesise prevention and management strategies applicable to this cohort.

Methods: A hospital-based cross-sectional analytical study enrolled 240 confirmed MetS patients at Index Medical College, Indore. Biochemical profile — fasting blood glucose (GOD-POD), serum creatinine (Jaffe's), blood urea (urease-GLDH), lipid profile (enzymatic colorimetric), and eGFR (CKD-EPI) — was assessed. Pearson correlation and multiple linear regression (SPSS v25.0) identified predictors of eGFR decline. Prevention strategies were mapped to biochemical findings.

Results: Mean serum creatinine was 1.12 ± 0.31 mg/dL; mean eGFR 61.87 ± 19.46 mL/min/1.73 m². Mean total cholesterol was 209.76 ± 34.28 mg/dL; LDL-C 133.46 ± 31.62 mg/dL; blood urea 32.48 ± 9.86 mg/dL. Fasting blood glucose was the strongest negative correlate of eGFR (r = −0.38, p < 0.01). Age (β = −0.29), fasting glucose (β = −0.26), systolic BP (β = −0.23), and BMI (β = −0.21) were independent predictors of eGFR decline (F = 9.84, p < 0.001; adjusted R² = 0.41). CKD burden escalated with increasing MetS component clustering. SGLT2 inhibitors, ACE inhibitors/ARBs, lifestyle modification, and structured screening were identified as evidence-based prevention pillars.

Conclusion: Hyperglycaemia, elevated BMI, hypertension, and advancing age are the principal determinants of renal dysfunction in Indian MetS patients. An integrated prevention framework targeting these predictors is recommended for clinical and public health implementation.