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Kidney Week

Abstract: FR-PO416

Epicardial Fat Is Associated with Traditional CV Risk Factors and Renal Function in Patients with Moderately Severe CKD

Session Information

Category: Chronic Kidney Disease (Non-Dialysis)

  • 301 CKD: Risk Factors for Incidence and Progression

Authors

  • Saritas, Turgay, University Hospital RWTH Aachen, Aachen, Germany
  • Schmöe, Jonas, University Hospital RWTH Aachen, Aachen, Germany
  • Nadal, Jennifer, University of Bonn, Bonn, Germany
  • Schmid, Matthias, University of Bonn, Bonn, Germany
  • Janka, Rolf, University of Erlangen-Nuernberg, Erlangen, Germany
  • Wanner, Christoph, University Hospital Wuerzberg, Wuerzburg, Germany
  • Eckardt, Kai-Uwe, University of Erlangen-Nuremberg, Erlangen, Germany
  • Floege, Jürgen, University Hospital RWTH Aachen, Aachen, Germany
  • Schneider, Markus P., University of Erlangen-Nuremberg, Erlangen, Germany
  • Schlieper, Georg, University Hospital RWTH Aachen, Aachen, Germany
Background

Pathological increase of epicardial adipose tissue (EAT) has been proposed as a novel, imaging-based predictor of CV events. How traditional CV risk factors associate with EAT enlargement in patients with moderately severe chronic kidney disease (CKD) has not been examined yet.

Methods

We analyzed data from 257 patients from CARVIDA (CARdioVascular In Depth Assessment), which is a multi-center substudy of the German Chronic Kidney Disease (GCKD) study. Patients were enrolled on the basis of an eGFR of 30-60 ml/min/1.73m2 or overt proteinuria, and EAT was measured by computed tomography. Multivariable association of EAT with CV risk factors (age, gender, BMI, smoking, diabetes mellitus, hypertensive nephropathy, cholesterol, HDL, eGFR (CKD-EPI equation) and urine albumin-to-creatinine (UACR)) was assessed using linear regression analysis. Framingham 10-year CV disease risk score and ACC-AHA 10-year atherosclerotic CV disease (ASCVD) risk score were calculated for each patient.

Results

EAT showed a median level of 121 cm3 (IQR: 81-162 cm3). Prevalence of traditional CV risk factors increased with quartiles of EAT (all p < 0.05). Using multivariable analysis, higher EAT was significantly associated with the majority of investigated risk factors (age, gender, BMI, smoking, HDL) (Table 1). Of note, lower eGFR was independently associated with increased EAT (OR 0.997 (95% CI: 0.994-0.999), p<0.05). Finally, EAT correlated with estimated 10-year risk for CV disease by Framingham (spearman rho = 0.257, p =0.002; median risk score: 18.5%) and ASCVD (spearman rho =0.192, p =0.020; median risk score: 13.7%).

Conclusion

Epicardial fat is associated with traditional CV risk factors in the presence of CKD. Moreover, we observed that lower eGFR is also associated with EAT. EAT may thus be an integrative risk marker and follow-up of our patients will determine whether assessment of EAT improves the prediction of CV events in CKD.

Associations between Cardiovascular Risk Factors and Epicardial Fat Volume as obtained from Multivariable Adjusted Linear Regression
 Odds Ratio95% CIP-value
Age
Male
BMI
Smoking
- Never smoked (reference)
- Former
- Current
Diabetes mellitus
Hypertensive Nephropathy
Cholesterol
HDL
eGFR
UACR
1.010
1.308
1.043

(reference)
1.146
1.183
0.982
1.087
1.000
0.997
0.997
1.000
1.006 - 1.014
1.189 - 1.439
1.034 - 1.052

(reference)
1.048 - 1.253
1.035 - 1.352
0.885 - 1.091
0.970 - 1.219
0.999 - 1.001
0.995 - 1.000
0.994 - 0.999
1.000 - 1.000
<0.0001
<0.0001
<0.0001

(reference)
0.003
0.014
0.738
0.150
0.503
0.048
0.005
0.158

Funding

  • Private Foundation Support