*2.8. Fatty Kidney*

Accumulation of ectopic fat in the kidney is receiving more attention in the last years and will increase with the development of techniques that allow for a better estimation than the classical echography and CT-scan. Apart from intra-renal accumulation in the proximal tubule and in minor grade in the glomeruli, fat in the renal sinus and around the renal capsule seems to play a role in the renal dysfunction of the obese patient. Renal sinus fat has been associated with CKD in the Framingham Heart Study [84]. Moreover, perirenal fat seems to produce lipotoxic effects on the kidney, increasing the glomerular hydrostatic pressure and the activity of the renin-angiotensin-aldosterone system, contributing to the progression of kidney damage [85].
