Evaluation of Risk Factors Associated with Epicardial Fat Tissue Thickness İn Patients with Stage 4 and Stage 5 Chronic Kidney Disease

Abstract Purpose: Chronic kidney disease (CKD) is a global public health issue, often associated with high mortality and morbidity, especially due to cardiovascular diseases. Epicardial adipose tissue (EAT), the visceral fat surrounding the heart, has been recognized as a significant factor in cardiovascular risk. This study aims to assess the relationship between EAT thickness and body composition in patients with stage 4 and 5 CKD usingbioelectrical impedance analysis (BIA). Methods: The study included 80 patients with stage 4 and 5 CKD who were not on dialysis. Body composition was measured using BIA, and EAT thickness was assessed using transthoracic echocardiography. Exclusion criteria included heart failure, morbid obesity, pregnancy, and pacemaker use, among others. Various demographic, clinical, and biochemical parameters were also recorded. Results: Patients with stage 5 CKD had significantly higher EAT thickness compared to stage 4 CKD patients. EAT thickness showed a positive correlation with age, BMI, blood pressure, C-reactive protein (CRP), and triglyceride levels, and a negative correlation with albumin and HDL levels. Multivariate analysis revealed that increased systolic blood pressure, fat tissue mass, low HDL, and low albumin were independent predictors of EAT thickness. Conclusion: EAT thickness is higher in advanced CKD patients and is associated with several cardiovascular risk factors. Measuring EAT thickness in CKD patients using non-invasive methods like echocardiography could be valuable in predicting cardiovascular risks. Addressing the factors that contribute to increased EAT thickness may improve clinical outcomes for CKD patients.