Clinical impact of abdominal fat distribution measured by 3-D computed tomography volumetry on post-transplant renal function in recipients after living kidney transplantation: a retrospective study

Clin Exp Nephrol. 2019 Mar;23(3):415-424. doi: 10.1007/s10157-018-1643-6. Epub 2018 Sep 6.

Abstract

Background: Excessive visceral fat may decrease renal function because of metabolic derangements. The aim of this study was to evaluate the impact of abdominal fat distribution on renal function of recipients after kidney transplantation using the visceral adipose tissue (VAT)/subcutaneous adipose tissue (SAT) ratio.

Methods: Seventy-nine patients underwent living kidney transplantation from 2009 to 2017. Patients without a correct measurement of VAT and SAT, follow-up of < 6 months, or with kidney transplant rejection or a virus infection were excluded. VAT and SAT were calculated automatically by 3-D volume analyzer software in recipients prior to living kidney transplantation. Our primary aim was to identify abdominal fat distribution measured by CT associated with renal dysfunction (estimate glomerular filtration rate; eGFR < 45) at 6 month post renal transplantation in recipient.

Results: Fifty-eight living kidney recipients were included in this retrospective study: 30 for the high VAT/SAT ratio group; 28 for the VAT/SAT low group. Multiple logistic regression analysis showed the VAT/SAT ratio and pre-donor eGFR were associated with eGFR < 45 ml/min/1.73 m2. An increase in VAT/SAT ratio was associated independently with the incidence of decreased renal function.

Conclusion: This finding indicates that adipose tissue distribution is an important predictor of the outcome of living kidney transplantation in recipients.

Keywords: Abdominal fat; Computed tomography; Kidney transplantation; Renal dysfunction; VAT/SAT ratio.

MeSH terms

  • Abdominal Fat / anatomy & histology*
  • Abdominal Fat / diagnostic imaging
  • Adult
  • Aged
  • Glomerular Filtration Rate
  • Humans
  • Imaging, Three-Dimensional / methods*
  • Kidney Transplantation*
  • Lipids / blood
  • Living Donors*
  • Middle Aged
  • Retrospective Studies
  • Tomography, X-Ray Computed / methods*

Substances

  • Lipids