Adiposity and Kidney Disease Dynamics
Summary
Adiposity, particularly when involving ectopic fat depots around and within the kidney, plays a crucial role in the initiation and progression of kidney disease. Excess energy storage in perirenal and renal sinus regions contributes to local inflammation, vascular compression and altered haemodynamics, leading to reduced glomerular filtration rate and albuminuria. Systemic factors such as insulin resistance, dyslipidaemia and the release of adipokines and hepatokines further exacerbate renal injury by promoting oxidative stress, fibrosis and podocyte dysfunction. The interplay between metabolic overload and renal microenvironment underlies the increasing global burden of chronic kidney disease among individuals with obesity and type 2 diabetes. Improved imaging modalities and mechanistic insights have highlighted the adaptive and maladaptive roles of renal fat depots, offering potential targets for early detection and therapeutic intervention.
Research from Nature Portfolio
Recent studies have revealed that renal sinus fat (RSF) exerts a protective paracrine influence on glomerular endothelial cells and podocytes under healthy conditions, but this benefit is abolished in the presence of elevated levels of the hepatokine fetuin-A, as seen in fatty liver disease. In vitro co-culture models showed that fetuin-A shifts RSF signalling from anti-inflammatory to pro-inflammatory, while in vivo analyses demonstrated that individuals with non-alcoholic fatty liver disease and high RSF also exhibit lower estimated glomerular filtration rates and elevated urinary albumin–creatinine ratios. These findings underscore the importance of cross-talk between hepatic and renal fat depots in modulating kidney function.
Adiposity and Kidney Disease Dynamics publication trend
The graph below shows the total number of articles in adiposity and kidney disease dynamics across all publications each year (not limited to Nature Index journals).
Technical terms
Adiposity: The condition of having excess body fat, often quantified by body mass index or fat depots measured by imaging.
Ectopic fat deposition: Accumulation of adipose tissue in non-adipose organs, such as the liver or kidney, that is associated with metabolic dysfunction.
Renal sinus fat (RSF): A perivascular fat depot located within the renal hilum that surrounds vessels and lymphatics and can influence renal haemodynamics.
Perirenal adipose tissue (PRAT): The adipose compartment directly enveloping the kidney, implicated in paracrine signalling and fibrotic processes in kidney disease.
Glomerular filtration rate (GFR): A measure of kidney function indicating the volume of blood filtered by glomeruli per unit time, often estimated clinically (eGFR).
Hepatokine: A liver-derived bioactive protein that can influence systemic and organ-specific metabolism, such as fetuin-A modulating RSF activity.
References
- Obesity Is Associated with Fatty Liver and Fat Changes in the Kidneys in Humans as Assessed by MRI. Nutrients (2024).
- Upregulation in Inflammation and Collagen Expression in Perirenal but Not in Mesenteric Adipose Tissue from Diabetic Munich Wistar Frömter Rats. International Journal of Molecular Sciences (2023).
- Renal sinus fat and renal hemodynamics: a cross-sectional analysis. Magnetic Resonance Materials in Physics, Biology and Medicine (2019).
- The protective effect of human renal sinus fat on glomerular cells is reversed by the hepatokine fetuin-A. Scientific Reports (2017).
- Changes in Kidney Fat upon Dietary-Induced Weight Loss. Nutrients (2022).
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