Renal sinus fat and renal hemodynamics: a cross-sectional analysis

• Published in: Magma (New York, N.Y.) Vol. 33; no. 1; pp. 73 - 80
• Main Authors: Spit, Karlinde A., Muskiet, Marcel H. A., Tonneijck, Lennart, Smits, Mark M., Kramer, Mark H. H., Joles, Jaap A., de Boer, Anneloes, van Raalte, Daniel H.
• Format: Journal Article
• Language: English
• Published: Cham Springer International Publishing 01-02-2020
• Subjects: Adult; Aged; Biomedical Engineering and Bioengineering; Body Mass Index; Computer Appl. in Life Sciences; Cross-Sectional Studies; Diabetes Mellitus, Type 2 - complications; Diabetes Mellitus, Type 2 - diagnostic imaging; Female; Health Informatics; Hemodynamics; Humans; Hypertension - complications; Imaging; Inulin - metabolism; Kidney - blood supply; Kidney - diagnostic imaging; Kidney - physiopathology; Kidney Failure, Chronic - diagnostic imaging; Kidney Failure, Chronic - physiopathology; Magnetic Resonance Imaging; Male; Medicine; Medicine & Public Health; Middle Aged; Radiology; Research Article; Solid State Physics; Hypertension; Type 2 diabetes; Renal hemodynamics; Renal sinus fat; Diabetic kidney disease
• ISSN: 0968-5243; 1352-8661
• DOI: 10.1007/s10334-019-00773-z

Objectives
Increased renal sinus fat (RSF) is associated with hypertension and chronic kidney disease, but underlying mechanisms are incompletely understood. We evaluated relations between RSF and gold-standard measures of renal hemodynamics in type 2 diabetes (T2D) patients.
Methods
Fifty-one T2D patients [age 63 ± 7 years; BMI 31 (28–34) kg/m
2
; GFR 83 ± 16 mL/min/1.73 m
2
] underwent MRI-scanning to quantify RSF volume, and subcutaneous and visceral adipose tissue compartments (SAT and VAT, respectively). GFR and effective renal plasma flow (ERPF) were determined by inulin and PAH clearances, respectively. Effective renal vascular resistance (ERVR) was calculated.
Results
RSF correlated negatively with GFR (
r
 = − 0.38;
p
 = 0.006) and ERPF (
r
 = − 0.38;
p
 = 0.006) and positively with mean arterial pressure (MAP) (
r
 = 0.29;
p
 = 0.039) and ERVR (
r
 = 0.45,
p
 = 0.001), which persisted after adjustment for VAT, MAP, sex, and BMI. After correction for age, ERVR remained significantly related to RSF.
Conclusions
In T2D patients, higher RSF volume was negatively associated to GFR. In addition, RSF volume was positively associated with increased renal vascular resistance, which may mediate hypertension and CKD development. Further research is needed to investigate how RSF may alter the (afferent) vascular resistance of the renal vasculature.