الفهرس 
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Abstract
Obesity is now recognized as a risk factor for the development of renal dysfunction, with a growing body of evidence supporting the association of higher body mass index and chronic kidney disease.
Renal sinus fat may exert influence on hypertension and CV risk through one of several mechanisms. Compression of blood vessels, lymph vessels, and ureters in the renal sinus (sinus lipomatosis) may obstruct the renal outflow tract and increase intrarenal hydrostatic pressure. As a result, kidney size may increase. This observation has been previously shown in animal studies, in which obese rabbits exhibited larger kidneys (30%) with larger fat deposits within the renal sinus. This occurred due to renal lymphatic compression, despite an absence of detectable fat accumulation within the renal parenchyma.
So the aim of our study was to assess frequency of fatty change in kidney of Renal Transplant Recipients and possible associated factors.
The study included 40 patients with renal transplant and 40 participants as control group.
Renal transplant group was divided according to, body mass index into: Normal body mass index, Overweight and Obese subgroups and according to blood pressure into: Normotensive, Hypertensive controlled and Hypertensive uncontrolled subgroups.
We assessed fatty infiltration of renal graft was done using CT and searched for possible associated factors using, comparisons between subgroups and control group and correlations with clinical and laboratory data including Insulin resistance and Lipid profile.
Mean age of kidney transplant group was 42.2 + 9.79 years, all were males. Only 6 of them (15%) have preemptive transplantation; the most common cause of (ESRD) among our participants was hypertensive nephropathy (45%) followed by chronic glomerulonephritis (GN) (15%), Obstructive uropathy (5.0 %) and Adult Poly Cystic Kidney Disease (APKD) (5.0 %) while (30%) of cases have no definitive cause. Diabetic patients were excluded in our study.
Twenty nine patients (72.5%) have Hypertension and eight patients (20%) have viral Hepatitis infection (seven patients with HCV while one patient with HBV infection), while eleven patients (27.5%) don’t have co-morbidities.
The incidence of Fatty kidney between normotensive patients with renal transplantation = 27.27%, Hypertensive controlled patients = 46.66% and Hypertensive uncontrolled patients = 57.14%.
We found that Perimeter of kidney and Perimeter of sinus fat were significantly higher in kidney transplant group than control group and that Perimeter of transplanted kidney and Perimeter of sinus fat were significantly higher in patients subgroups (Normotensive, Hypertensive controlled and Hypertensive uncontrolled) than control group.
We also found that there was a highly statisticlly significant difference between control group and hypertensive controlled group as regard perimeter of sinus fat. Also There was a highly statistically significant difference between control group and hypertensive uncontrolled group as regard perimeter of sinus fat; There was a statistically significant difference between normotensive group and hypertensive uncontrolled group as regard perimeter of sinus fat.
Our results show that that there was a highly significant difference between control group and hypertensive controlled group as regard Ratio between perimeter of renal sinus fat and perimeter of transplanted kidney; There was a statistically significant difference between control group and hypertensive uncontrolled group as regard Ratio between perimeter of renal sinus fat and perimeter of transplanted kidney. Also There was a statistically significant difference between hypertensive controlled group and normotensive group as regard Ratio between perimeter of renal sinus fat and perimeter of transplanted kidney.
We found also that Perimeter of kidney and Perimeter of sinus fat were significantly higher in overweight and Obese groups than control group.
Our study found that incidence of fatty kidney in transplant group according to Ratio between perimeter of renal sinus fat and perimeter of kidney range in control group was 40.0%(>16.7%), and 45%(>442.2mm) according to perimeter of sinus fat in control group.
We also found that there was a highly statistically significant difference between control group and overweight group as regard perimeter of sinus fat. Also There was a highly statistically significant difference between control group and obese group as regard perimeter of sinus fat; There was a statistically significant difference between control group and normal weight group as regard perimeter of sinus fat.
Also, there was a highly significant difference between control group and Normal weight group as regard Ratio between perimeter of renal sinus fat and perimeter of transplanted kidney; There was a statistically significant difference between control group and overweight group as regard Ratio between perimeter of renal sinus fat and perimeter of transplanted kidney.
We found a significant positive correlation between (Ratio between perimeter of renal sinus fat and perimeter of kidney) and Body mass index in control group, also there is a significant positive correlation between (Ratio between perimeter of renal sinus fat and perimeter of transplanted kidney) and (Body mass index and weight) in Hypertensive controlled group.
We also found that Perimeter of transplanted kidney was higher in Overweight and obese group than Normal weight group.
Also, Perimeter of transplanted kidney was significantly higher in hypertensive controlled group and hypertensive uncontrolled group than normotensive group.
Our results show that there is a statistically positive correlation between Systolic blood pressure and Perimeter of transplanted kidney and that there is a statistically positive correlation between perimeter of sinus fat and perimeter of transplanted kidney.
We found that there is a highly significant positive correlation between perimeter of sinus fat with waist circumference, weight and BMI in all studied patients and that there is a highly significant positive correlation between perimeter of sinus fat with height, waist circumference, weight and BMI in control group.
We also found that there is highly significant positive correlation between perimeter of sinus fat and waist circumference, weight body mass index and perimeter of the kidney, and also a statistically significant positive correlation with age in all studied subjects.
Our results show that Waist circumference and Perimeter of transplanted kidney are independent significant predictors of Perimeter of sinus fat.