Evaluation of risk factors associated with epicardial fat tissue thickness in patients with stage 4 and stage 5 chronic kidney disease

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 and body composition in patients with stage 4 and 5 CKD using bioelectrical 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 was assessed using transthoracic echocardiography(ECHO). 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 (6.7 ± 0.12) had significantly higher EAT compared to stage 4 CKD (5.9 ± 0.09) patients. EAT 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(SBP)(p:0.019),fat tissue mass (FTM)(p < 0.001), low HDL(p: 0.027), and low albumin(p < 0.001) were independent predictors of EAT. Conclusion: EAT is higher in advanced CKD patients and is associated with several cardiovascular risk factors. Measuring EAT in CKD patients using non-invasive methods like ECHO could be valuable in predicting cardiovascular risks. Addressing the factors that contribute to increased EAT may improve clinical outcomes for CKD patients. © The Author(s), under exclusive licence to Springer Nature B.V. 2025.