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Usefulness of visceral adipose tissue estimation in the prevention of chronic kidney disease in hypertensive patients in primary health care

Ana Karina Teixeira da Cunha França, Alcione Miranda dos Santos, João Victor Salgado, Antônio Augusto Moura Da Silva, Valdinar de Sousa Ribeiro, Nayra Anielly Cabral Cantanhede, Michele Bezerra Silva, Elisângela Milhomem dos Santos, Natalino Salgado Filho

Background: studies have shown an association between obesity and a reduction in estimated glomerular fi ltration rate (eGFR). However, little is known regarding whether this association is related to total fat or, more specifi cally, to central or visceral fat.Objective: this study evaluated the correlations among the nutritional indices that measure total, central and visceral obesity with eGFR.Methods: a cross-sectional study, involving 288 hypertensive patients. Kidney function was estimated by GFR, using the Modifi cation of Diet in Renal Disease (MDRD) and Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) equations. Explanatory variables included body mass index (BMI), waist circumference (WC), waist-hip ratio (WHR), waist stature ratio (WSR), estimated visceral adipose tissue (eVAT) and body fat percentage (BF%).Results: the mean BMI was 27.8 ± 4.7 kg/m². Most of the patients (68.1%) were in the normal range of BF%, but regarding WC and eVAT, they were at very high risk (58.3% and 64.6%, respectively). In men, there were no correlations between nutritional indices and eGFR. In women, only eVAT remained negatively correlated with eGFR, estimated by MDRD and CKD-EPI equations, independent of BMI, smoking, physical inactivity, blood pressure, glycated hemoglobin, LDL and HDL cholesterol, uric acid and microalbuminuria.Conclusions: the majority of obesity indices were not associated with eGFR. Only eVAT was negatively associated with eGFR by MDRD and CKDEPI equations in hypertensive women. In primary health care, visceral adipose tissue estimation could support the identifi cation of hypertensive women at increased risk for developing chronic kidney disease.

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