Kidney Week

Abstract: TH-PO390

Visceral Adiposity Is Strongly Associated With Kidney Growth in Early-Stage Autosomal Dominant Polycystic Kidney Disease (ADPKD)

Session Information

• Genetic Diseases of the Kidneys: Cystic - I
  November 03, 2022 | Location: Exhibit Hall, Orange County Convention Center‚ West Building
  Abstract Time: 10:00 AM - 12:00 PM

Category: Genetic Diseases of the Kidneys

• 1101 Genetic Diseases of the Kidneys: Cystic

Authors

• Nowak, Kristen L., University of Colorado - Anschutz Medical Campus, Aurora, Colorado, United States

Kristen L. Nowak,

• Steele, Cortney, University of Colorado - Anschutz Medical Campus, Aurora, Colorado, United States

Cortney Steele,

• You, Zhiying, University of Colorado - Anschutz Medical Campus, Aurora, Colorado, United States

Zhiying You,

• Ramanathan, Sumana, Mayo Clinic Minnesota, Rochester, Minnesota, United States

Sumana Ramanathan,

• Gregory, Adriana, Mayo Clinic Minnesota, Rochester, Minnesota, United States

Adriana Gregory,

• Gitomer, Berenice Y., University of Colorado - Anschutz Medical Campus, Aurora, Colorado, United States

Berenice Y. Gitomer,

• Chonchol, Michel, University of Colorado - Anschutz Medical Campus, Aurora, Colorado, United States

Michel Chonchol,

• Kline, Timothy L., Mayo Clinic Minnesota, Rochester, Minnesota, United States

Timothy L. Kline,

Group or Team Name

• HALT-PKD trial

Background

We have previously described that overweight and obesity, measured by body-mass index (BMI), are associated with kidney disease progression in individuals with early stage ADPKD. Adipocytes do not simply act as a fat reservoir, but are active endocrine organs, and particularly in visceral adipose tissue, can promote release of pro-inflammatory cytokines and adipokines. Numerous signaling pathways promoted by adipocytes are also implicated in cystogenesis, potentially by promoting a pro-cystogenic milieu. We hypothesized that greater abdominal adiposity would be associated with more rapid kidney growth in early-stage ADPKD patients.

Methods

60 non-diabetic participants with ADPKD and estimated glomerular filtration rate (eGFR) >60 ml/min/1.73m² who participated in HALT Study A and had magnetic resonance imaging (MRI) with full coverage of visceral adipose tissue were selected. Body composition parameters, including subcutaneous and visceral adipose tissue, were calculated. The L3-level was determined based on sagittal views and the center slice was selected at the L3-level axial slice. The tissue regions were segmented using ITK-Snap in the axial view and area was calculated by the product of the number of voxels and the in-plane image resolution. The longitudinal (5-yr) association of abdominal adiposity (interaction of visceral, subcutaneous, and total adiposity with time) with height-corrected total kidney volume (htTKV) by MRI was evaluated using linear mixed effects regression models.

Results

Mean+s.d. age was 39±7 years, eGFR was 89±16 ml/min/1.73m², and median (IQR) htTKV was 605 (409, 935) ml/m. Greater abdominal subcutaneous (β-estimate 0.16 [95% CI 0.016, 0.30]; all values are presented as x10²; p=0.03), visceral (β-estimate 0.22 [95% CI 0.13, 0.31]; p<0.0001), and total abdominal adipose tissue (β-estimate 0.28 [95% CI 0.15, 0.41]; p<0.0001) were associated with a greater increase in htTKV after adjustment for demographics, study randomization, clinical characteristics including eGFR, baseline liver volume, and genotype.

Conclusion

Abdominal adiposity, and particularly visceral adiposity, are strongly and independently associated with longitudinal increase in htTKV in a small cohort of patients with early-stage ADPKD.

Funding

• NIDDK Support