Perirenal fat thickness is associated with metabolic risk factors in patients with chronic kidney disease
Luis D’Marco1,2 , Juan Salazar4 , Marie Cortez2 , María Salazar2 , Marjorie Wettel2 , Marcos Lima-Martínez3 , Edward Rojas5 , Willy Roque5 , Valmore Bermúdez4
1Consorci Sanitari del Garraf, Servicio de Nefrología, Barcelona, Spain
2Advanced Unit of Renal Sonographic Diagnostics, Puerto Ordaz Clinic, Puerto Ordaz City, Venezuela
3Department of Physiological Sciences, Universidad de Oriente, Bolívar, Venezuela
4Universidad Simon Bolívar Facultad de Ciencias de la Salud, Barranquilla, Colombia
5Rutgers, The State University of New Jersey, New Brunswick, NJ, USA
Correspondence to: Luis D’Marco
Consorci Sanitari del Garraf, Servicio de Nefrología, Barcelona 08811, Spain. E-mail: luisgerardodg@hotmail.com
Received: December 12, 2018; Revised: March 30, 2019; Accepted: April 11, 2019; Published online: July 30, 2019.
© The Korean Society of Nephrology. All rights reserved.

This is an open-access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc-nd/4.0/), which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
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 m2) 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 m2, 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.
Keywords: Cardiovascular, Chronic kidney disease, Diabetes, Metabolic risk, Perirenal fat, Renal insufficiency


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