title: Fatty kidney, hypertension, and chronic kidney disease: the Framingham Heart Study.
abstract: Ectopic fat depots may mediate local and systemic disease. Animal models of diet-induced obesity demonstrate increased fat accumulation in the renal sinus. The association of renal sinus fat with hypertension, chronic kidney disease, and other metabolic disorders has not been studied in a large, community-based sample. Participants from the Framingham Heart Study (n=2923; mean age: 54 years; 51% women) underwent quantification of renal sinus fat area using computed tomography. High renal sinus fat ("fatty kidney") was defined using sex-specific 90th percentiles in a healthy referent subsample. Multivariable linear and logistic regression was used to model metabolic risk factors as a function of fatty kidney and log-transformed renal sinus fat. Multivariable models were adjusted for age, sex, and outcome-specific covariates and then additionally adjusted for body mass index or abdominal visceral adipose tissue. The prevalence of fatty kidney was 30.1% (n=879). Individuals with fatty kidney had a higher odds ratio (OR) of hypertension (OR: 2.12; P<0.0001), which persisted after adjustment for body mass index (OR: 1.49; P<0.0001) or visceral adipose tissue (OR: 1.24; P=0.049). Fatty kidney was also associated with an increased OR for chronic kidney disease (OR: 2.30; P=0.005), even after additionally adjusting for body mass index (OR: 1.86; P=0.04) or visceral adipose tissue (OR: 1.86; P=0.05). We observed no association between fatty kidney and diabetes mellitus after adjusting for visceral adipose tissue. In conclusion, fatty kidney is a common condition that is associated with an increased risk of hypertension and chronic kidney disease. Renal sinus fat may play a role in blood pressure regulation and chronic kidney disease.
authors.affiliation: Framingham Heart Study, Framingham, MA, USA. foxca@nhlbi.nih.gov
authors.forename: Meredith C
authors.initials: MC
authors.lastname: Foster
authors.forename: Shih-Jen
authors.initials: SJ
authors.lastname: Hwang
authors.forename: Stacy A
authors.initials: SA
authors.lastname: Porter
authors.forename: Joseph M
authors.initials: JM
authors.lastname: Massaro
authors.forename: Udo
authors.initials: U
authors.lastname: Hoffmann
authors.forename: Caroline S
authors.initials: CS
authors.lastname: Fox
mesh_terms: D017677:Age Distribution; D000368:Aged; D000886:Anthropometry; D001795:Blood Pressure Determination; D015992:Body Mass Index; D002318:Cardiovascular Diseases / Q000175:diagnosis / Q000453:epidemiology*; D016022:Case-Control Studies; D015897:Comorbidity; D005260:Female; D006334:Heart Function Tests; D006801:Humans; D006973:Hypertension / Q000175:diagnosis / Q000453:epidemiology*; D015994:Incidence; D050152:Intra-Abdominal Fat / Q000503:physiopathology*; D007677:Kidney Function Tests; D008297:Male; D008404:Massachusetts; D008875:Middle Aged; D011379:Prognosis; D051436:Renal Insufficiency, Chronic / Q000175:diagnosis / Q000453:epidemiology*; D012189:Retrospective Studies; D018570:Risk Assessment; D012720:Severity of Illness Index; D017678:Sex Distribution; D015996:Survival Rate