The Framingham Heart Study and chronic kidney disease

http://www.ncbi.nlm.nih.gov/pubmed/21931075

Hypertension. 2011 Sep 19. [Epub ahead of print]
Fatty Kidney, Hypertension, and Chronic Kidney Disease: The Framingham Heart Study.
Foster MC, Hwang SJ, Porter SA, Massaro JM, Hoffmann U, Fox CS.
Source
Framingham Heart Study, Framingham, MA; Division of Intramural Research and the Center for Population Studies, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, MD; Department of Epidemiology, Harvard School of Public Health, Boston, MA; Division of Endocrinology and Metabolism, Brigham and Women's Hospital, Harvard Medical School, Boston, MA; Department of Biostatistics, Boston University School of Public Health, Boston, MA; Department of Radiology, Massachusetts General Hospital, Boston, MA.

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.