#6732 epicardial adipose tissue and reverse epidemiology in dialysis patients

Abstract Background and Aims Conventional risk factors of cardiovascular disease and mortality in the general population such as body mass is relate to adverse outcome in dialysis patients, but often in an opposite direction (reverse epidemiology). On the contrary, epicardial adipose tissue (EAT) has reported to have a local inflammatory and proatherogenic effect. Thus, the association of EAT as direct measures of region specific adipose tissue in chronic kidney disease (CKD) has been studied. Method The study evaluated 37 CKD-5 patients in hemodialysis (mean dialysis duration 26±30 months, 70% males, 57% African-American, 48% diabetic) that underwent MSCT to measure EAT and coronary artery calcium (CAC) score. CAC distribution in quartiles of EAT was assessed. Finally, we measured patients’ body mass index (BMI) and categorized them as normal (BMI 18.5-25 kg/m2) and abnormal BMI (BMI >25 kg/m2). Results The mean BMI was 28.6±5.7 kg/m2, and the mean EAT volume was 66±29 ml and 102±69 ml for normal and abnormal BMI groups. There was a direct correlation between dialysis vintage and EAT while BMI showed an inverse relationship with dialysis vintage (p = 0.05). In this small sample size, the association of CAC and EAT was only marginally significant (p = 0.7). EAT was significantly correlated with age (p = 0.02), history of cardiovascular disease (p = 0.03) and diabetes (p = 0.001). Conclusion The direct association of EAT with dialysis vintage in the face of an inverse association of BMI with dialysis duration appear to support the notion that chronic hemodialysis is a state of chronic inflammation and malnutrition.