Perirenal fat thickness is associated with metabolic risk factors in patients with chronic kidney disease

Abstract

Background Adipose tissue accumulation in specific body compartments has been associated with diabetes, hypertension and dyslipidemia. Perirenal fat (PRF) may lead to have direct lipotoxic effects on renal function and intrarenal hydrostatic pressure. This study was undertaken to explore the association of PRF with cardiovascular risk factors and different stages of chronic kidney disease (CKD). Methods We studied 103 patients with CKD of different stages (1 to 5). PRF was measured by B-mode renal ultrasonography in the distal third between the cortex and the hepatic border and/or spleen. Results The PRF thickness was greater in CKD patients with impaired fasting glucose than in those with normal glucose levels (1.10 ± 0.40 cm vs. 0.85 ± 0.39 cm, P < 0.01). Patients in CKD stages 4 and 5 (glomerular filtration rate [GFR] < 30 mL/min/1.73 m 2 ) had the highest PRF thickness. Serum triglyceride levels correlated positively with the PRF thickness; the PRF thickness was greater in patients with triglyceride levels ≥ 150 mg/dL (1.09 ± 0.40 cm vs. 0.86 ± 0.36 cm, P < 0.01). In patients with a GFR < 60 mL/min/1.73 m 2 , uric acid levels correlated positively with the PRF thickness ( P < 0.05). Conclusion In CKD patients, the PRF thickness correlated significantly with metabolic risk factors that could affect kidney function.

Metabolic Surgery to Treat Obesity in Diabetic Kidney Disease, Chronic Kidney Disease, and End-Stage Kidney Disease; What Are the Unanswered Questions?

“…Incidence of CKD also increased significantly across tertiles of increasing PUFT (109). In people with CKD, peri-renal fat thickness (PRFT) associates with metabolic risk factors for CKD progression such as higher fasting blood glucose, elevated blood triglycerides and hyperuricemia (110).…”

Perirenal Adipose Tissue—Current Knowledge and Future Opportunities

“…Due to its anatomical location, PRAT’s size increase may lead to chronic kidney damage, with a direct correlation between the thickness of this adipose tissue deposit and the kidney damage [ 31 ]. According to this observation, the ultrasound evaluation of PRAT volume is nowadays proposed as a parameter for the assessment of early renal lesions associated with obesity [ 32 ].…”

“…In addition, PRAT compression of the renal parenchyma causes an increased interstitial hydrostatic pressure and a reduced renal blood flow, which result in stimulation of renin secretion, glomerular filtration, and tubular sodium reabsorption, respectively, all these processes accelerating the kidney disease progression ( Figure 1 ) [ 10 , 31 , 36 ].…”

“…In this context, a recent study on 296 patients with hypertensive disease has shown that glomerular filtration rate reduction of <60 mL/minutes per 1.73 m 2 is correlated to PRAT increase not to that of visceral adiposity, regardless of gender [ 37 ]. Moreover, a direct link between PRAT size and patients’ high serum uric acid and triglycerides, in chronic kidney disease [ 31 ] or with creatinin values, in hypertensive disease has been registered [ 37 ] as a consequence of glomerular filtration rate reduction [ 10 ].…”

“…During the last years, research has shown that the cardiovascular risk is more closely correlated with visceral fat tissue volume, including PRAT, in comparison to subcutaneous fat size [ 7 , 31 , 50 ]. In this regard, a recent study, conducted on a group of 702 overweight prepubertal children, revealed a relationship between PRAT size and carotid intima-media thickness [ 51 ].…”