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A study of perirenal and epicardial fat thickness, oxidative stress, inflammation, and metabolic risk in pre-dialysis diabetic and non-diabetic CKD patients

Int Urol Nephrol. 2026 May 18. doi: 10.1007/s11255-026-05193-2. Online ahead of print.

ABSTRACT

AIM AND OBJECTIVES: This study aimed to evaluate perirenal and epicardial fat thickness and examine their associations with oxidative stress, inflammation, and metabolic markers in pre-dialysis CKD patients (diabetic and non-diabetic) compared with healthy controls.

MATERIAL AND METHODS: This cross-sectional study included 90 participants (30 diabetic CKD, 30 non-diabetic CKD, and 30 controls). Perirenal fat thickness was assessed by ultrasonography and epicardial fat thickness by echocardiography. Biochemical parameters including renal function, lipid profile, hs-CRP, malondialdehyde (MDA), and ferric reducing antioxidant power (FRAP) were measured. Statistical analysis was performed using parametric or non-parametric tests based on data distribution, with multivariate regression adjusting for age, sex, and BMI.

RESULTS: DKD patients had significantly higher perirenal (32.1 ± 5.0 mm) and epicardial (8.72 ± 1.89 mm) fat thickness compared to non-DKD patients and controls. DKD patients also exhibited increased oxidative stress (MDA 4.65 ± 3.39 µmol/L) and decreased antioxidant capacity (FRAP 0.25 ± 0.16 mmol/L). The inflammatory marker hs-CRP was significantly elevated in DKD patients [8.53 (12.64) mg/L]. No significant differences were observed in lipid profiles or atherogenic indices between groups; however, visceral adiposity showed significant positive correlations with atherogenic indices.

CONCLUSION: Pre-dialysis CKD patients, particularly those with diabetes, exhibit increased visceral adiposity along with higher oxidative stress and inflammation. Although atherogenic indices were not significantly different between groups, their association with visceral fat suggests a potential role of regional adiposity as a marker of metabolic risk; however, longitudinal studies are required to establish the prognostic significance.

PMID:42149464 | DOI:10.1007/s11255-026-05193-2

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