D'Marco Luis, Salazar Juan, Cortez Marie, Salazar María, Wettel Marjorie, Lima-Martínez Marcos, Rojas Edward, Roque Willy, Bermúdez Valmore
Consorci Sanitari del Garraf, Servicio de Nefrología, Barcelona, Spain.
Advanced Unit of Renal Sonographic Diagnostics, Puerto Ordaz Clinic, Puerto Ordaz City, Venezuela.
Kidney Res Clin Pract. 2019 Sep 30;38(3):365-372. doi: 10.23876/j.krcp.18.0155.
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).
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.
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, < 0.01). Patients in CKD stages 4 and 5 (glomerular filtration rate [GFR] < 30 mL/min/1.73 m) 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, < 0.01). In patients with a GFR < 60 mL/min/1.73 m, uric acid levels correlated positively with the PRF thickness ( < 0.05).
In CKD patients, the PRF thickness correlated significantly with metabolic risk factors that could affect kidney function.
特定身体部位的脂肪组织堆积与糖尿病、高血压和血脂异常有关。肾周脂肪(PRF)可能对肾功能和肾内静水压产生直接的脂毒性作用。本研究旨在探讨PRF与心血管危险因素及慢性肾脏病(CKD)不同阶段之间的关联。
我们研究了103例不同阶段(1至5期)的CKD患者。通过B型肾脏超声在皮质与肝缘和/或脾之间的远端三分之一处测量PRF。
空腹血糖受损的CKD患者的PRF厚度大于血糖水平正常的患者(1.10±0.40厘米对0.85±0.39厘米,<0.01)。CKD 4期和5期(肾小球滤过率[GFR]<30毫升/分钟/1.73平方米)的患者PRF厚度最高。血清甘油三酯水平与PRF厚度呈正相关;甘油三酯水平≥150毫克/分升(1.09±0.40厘米对0.86±0.36厘米,<0.01)的患者PRF厚度更大。在GFR<60毫升/分钟/1.73平方米的患者中,尿酸水平与PRF厚度呈正相关(<0.05)。
在CKD患者中,PRF厚度与可能影响肾功能的代谢危险因素显著相关。