The impact of perivascular adipose tissue characteristics on incident cardiovascular events in non-dialysis chronic kidney disease patients

Introduction: Patients with chronic kidney disease (CKD) face a high risk of developing cardiovascular disease. However, the relationship between perivascular adipose tissue characteristics and incident cardiovascular outcomes in non-dialysis patients with CKD remains unclear. Methods: This was prospective, observational, cohort study. A total of 220 CKD patients (stages G2-G5) without prior cardiovascular disease were enrolled. Attenuations and volumes of peri-coronary adipose tissue (PCAT), thoracic peri-aortic adipose tissue (TAT), and epicardial adipose tissue (EAT) were measured by ECG-gated non-enhanced computed tomography scans. Total coronary artery (CAC) and thoracic aorta calcification (TAC) were quantified with Agatston scores. Results: ) correlating with increased events rates. Cox regression demonstrated EAT volume as an independent predictor of incident cardiovascular outcomes. A multivariable model showed EAT volume enhanced the Framingham risk score's predictive value, achieving an area under the curve (AUC) of 0.76 (95% CI 0.66-0.87). Conclusion: These findings suggest EAT volume significantly predicts incident cardiovascular events in non-dialysis CKD patients.