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Long-Term Continuous Measurement of Renal Blood Flow in Conscious Rats
Published on: February 8, 2022
Relation between waist circumference and the renal hemodynamic in healthy individuals
Agnes Bosch1, Dennis Kannenkeril1, Christian Ott2
1Department of Nephrology and Hypertension, Friedrich-Alexander-University Erlangen-Nürnberg (FAU), Germany.
Insights
Higher waist circumference (WC) in healthy individuals is linked to reduced kidney function, including lower glomerular filtration rate (GFR) and renal plasma flow (RPF). This may be due to increased renal vascular resistance (RVR).
Area of Science:
- Nephrology
- Metabolic Health
- Cardiovascular Physiology
Background:
- Obesity is a known risk factor for chronic kidney disease (CKD).
- The specific impact of visceral fat, estimated by waist circumference (WC), on renal hemodynamics in healthy individuals is not well understood.
- Investigating the interplay between visceral fat, metabolic factors, and kidney function is crucial.
Purpose of the Study:
- To examine the relationship between waist circumference (WC) and renal hemodynamic profiles in healthy, non-obese individuals.
- To determine if increased visceral fat mass affects glomerular filtration rate (GFR), renal plasma flow (RPF), and intra-renal pressures.
- To explore the role of metabolic factors like leptin and HOMA-IR in this association.
Main Methods:
- Post-hoc analysis of 80 healthy participants from a randomized clinical trial.
- Division of participants into high WC and low WC groups based on median WC.
- Assessment of renal hemodynamic profiles using steady-state input clearance (para-aminohippuric acid and inulin infusion).
- Calculation of intraglomerular pressure (IGP) and arteriolar resistances (RA, RE) using the Gomez equation.
Main Results:
- The high WC group exhibited significantly lower GFR, RPF, and IGP compared to the low WC group.
- Individuals with high WC showed increased renal vascular resistance (RVR), afferent arteriolar resistance (RA), and efferent arteriolar resistance (RE).
- Higher leptin levels and HOMA-IR were observed in the high WC group.
Conclusions:
- Increased WC in healthy young individuals is associated with impaired renal hemodynamics.
- Reduced GFR and RPF in individuals with higher WC may be mediated by increased renal vascular resistance.
- Visceral fat accumulation, even in non-obese individuals, can negatively impact kidney function.
Background And Aims:
Obesity has been shown to be an independent risk factor for the development of CKD. Little is known about pathways of interaction of visceral fat mass estimated by waist circumference (WC) and metabolic factors with the renal and intraglomerular hemodynamic profile in healthy, non-obese individuals.
Methods And Results:
The study population of this post-hoc analysis in 80 healthy individuals, who participated in a randomized, controlled clinical trial (www.
Clinicaltrials:
gov: NCT02783456) was divided into two groups based on median of WC (high WC and low WC group). Renal hemodynamic profiles were analyzed using steady state input clearance (infusion of para-amino-hippuric acid and inulin). Intraglomerular pressure (IGP) and resistances of the afferent (RA) and efferent (RE) arterioles were calculated (Gomez equation). The analysis included healthy, non-smoking individuals, aged 27 ± 9 years with median WC of 84.75 ± 9 cm. Glomerular filtration rate (GFR) (110 ± 15 vs. 127 ± 16 ml/min/m2, p < 0.001), renal plasma flow (RPF) (620 ± 109 vs. 700 ± 104 ml/min, p = 0.001) and IGP (36.7 ± 2.3 vs. 38.5 ± 3.1 mmHg, p = 0.003) were lower in the high WC compared to the low WC group. Patients in the high WC group showed higher renal vascular resistance (RVR) (85 ± 19 vs. 70 ± 12 mmHg/(ml/min), p < 0.001), higher RA (4034 ± 1177 vs. 3069 ± 786 dyn∗s/cm5, p < 0.001) and higher RE (2283 ± 339 vs. 2118 ± 280 dyn∗s/cm5, p = 0.021) compared to the low WC group. Individuals in the high WC group showed higher leptin levels (p = 0.003) and higher HOMA-IR (p = 0.024) compared to the low WC group.
Conclusion:
Increased WC in healthy young individuals was associated with reduced GFR and RPF likely mediated by increased RVR.
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