Perirenal Fat and Kidney Function Deterioration in Patients With Acute Decompensated Heart Failure

Background and Objectives: The thick perirenal fat pad can induce high intracapsular pressure and cause compression of the renal vasculature and resultant congestive nephropathy. The current study investigated the association of perirenal fat thickness with kidney dysfunction in patients with acute decompensated heart failure (ADHF). Methods: Data from 266 patients hospitalized with ADHF were analyzed. Patients were divided into two groups according to the glomerular filtration rate (GFR) at admission (preserved kidney function [GFR ≥60 mL/min/1.73 m²] and reduced kidney function [GFR <60 mL/min/1.73 m²] groups). Right and left posterior perirenal fat thicknesses were measured using computed tomography, and their average values were calculated. Associated factors with reduced kidney function was assessed by logistic regression model, presenting with odds ratio (OR) and confidence interval (CI). Results: Increasing age (OR, 1.08; 95% CI, 1.04–1.12; p<0.001), diabetes mellitus (OR, 2.46; 95% CI, 1.18–5.12; p<0.017), increased log N-terminal pro-B-type natriuretic peptide (NT-proBNP) (OR, 1.82; 95% CI, 1.32–2.52; p<0.001), and increased average perirenal fat thickness (OR, 1.11; 95% CI, 1.06–1.16; p<0.001) were independently associated with reduced kidney function. In the subgroup analyses, patients over 70 years old, the ratio of mitral-to-mitral annular velocity >15, elevated log NT-proBNP had a significantly higher association with increased perirenal fat thickness with reduced kidney function. Conclusions: Thick perirenal fat pads were independently associated with kidney function deterioration in patients hospitalized with ADHF.