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

Background: studies have shown an association between obesity and a reduction in estimated glomerular filtration rate (eGFR). However, little is known regarding whether this association is related to total fat or, more specifically, 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 Modification 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/m(2). 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 CKD-EPI equations in hypertensive women. In primary health care, visceral adipose tissue estimation could support the identification of hypertensive women at increased risk for developing chronic kidney disease.