Ectopic fat depots may mediate local and systemic disease. Animal models of diet-induced obesity demonstrate increased fat accumulation in the renal sinus. The association of renal sinus fat with hypertension, chronic kidney disease, and other metabolic disorders has not been studied in a large, community-based sample. High renal sinus fat (“fatty kidney”) was defined using sex-specific 90th percentiles in a healthy referent subsample. Multivariable linear and logistic regression was used to model metabolic risk factors as a function of fatty kidney and log-transformed renal sinus fat. Multivariable models were adjusted for age, sex, and outcome-specific covariates and then additionally adjusted for body mass index or abdominal visceral adipose tissue. The prevalence of fatty kidney was 30.1%. Individuals with fatty kidney had a higher odd ratio (OR) of hypertension, which persisted after adjustment for body mass index or visceral adipose tissue. Fatty kidney was also associated with an increased OR for chronic kidney disease, even after additionally adjusting for body mass index or visceral adipose tissue (association between fatty kidney and diabetes mellitus after adjusting for visceral adipose tissue was observed. In conclusion, fatty kidney is a common condition that is associated with an increased risk of hypertension and chronic kidney disease. Renal sinus fat may play a role in blood pressure regulation and chronic kidney disease.
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