Three-dimensional evaluation of perirenal fat volume in patients with nephrolithiasis
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The concept of adipose tissue as an organ unto itself represents a new medical construct; already differences in the volume of perirenal fat around a tumor-bearing kidney have been described. We hypothesized that renal calculi may have similar impact on perirenal fat or alternatively abnormalities in urinary metabolites may be the result of perirenal fat affecting renal metabolism and subsequent stone formation. Accordingly, we conducted a study utilizing three-dimensional imaging software to evaluate perirenal fat volume (PFV) in patients with nephrolithiasis. Among 40 patients with a history of unilateral nephrolithiasis who underwent percutaneous nephrolithotomy between 2010 and 2016, the following data were acquired: body mass index, past medical history, stone characteristics and composition (i.e., calcium oxalate, calcium phosphate, uric acid, and struvite calculi). In addition, patients were stratified by dominant stone composition (≥ 50% fraction). Bilateral PFV measurements were obtained using the preoperative computed tomography scan and specialized three-dimensional imaging software. The PFV of stone-bearing kidneys was significantly greater than non-stone-bearing kidneys (397.3 and 323 cc, respectively; p = 0.004), with the PFV difference in patients with CO-dominant stone-bearing kidneys reaching statistical significance (p = 0.003). Subgroup analysis showed greater PFV surrounding the stone-bearing kidney irrespective of gender (p = 0.03), with male patients possessing significantly greater stone-bearing (p = 0.01) and bilateral PFV (p = 0.01) compared to females. No significant correlations were found between PFV and stone volume or stone density. The PFV of calcium oxalate stone-bearing kidneys is significantly greater than non-stone-bearing kidneys for both male and female patients with nephrolithiasis.
KeywordsNephrolithiasis Obesity Percutaneous nephrolithotomy Perirenal fat Visceral fat Adipose tissue
Body mass index
Perirenal fat volume
We would like to thank the following personnel for their contribution to the manuscript. Data collection: Anastasia Cruz MD, Mitchell Daun MD, and Adam Rudd MD. Data analysis: Tuyen Hoang PhD.
Compliance with ethical standards
Conflict of interest
Daniel J. Lama declares that he has no conflict of interest. Shoaib Safiullah declares that he has no conflict of interest. Albert Yang declares that he has no conflict of interest. Zhamshid Okhunov declares that he has no conflicts of interest. Jaime Landman declares that he has no conflict of interest. Ralph V. Clayman declares that he has no conflict of interest.
This article does not contain any studies with human participants or animals performed by any of the authors.
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