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The associations of pancreatic fat fraction (PFF) with adverse outcomes remain understudied.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We estimated baseline predicted PFF (pPFF) from abdominal magnetic resonance imaging (MRI) in 29\u2009447 UK Biobank participants. Since the initial imaging visit occurred 9.3 [interquartile range (IQR) 8.2\u201310.2] years after baseline visit, we calculated annual change in PFF using linear regression in 337 participants who underwent repeat imaging 2.8 (IQR 2.2\u20134.8) years after the initial scan. We back-calculated pPFF by adding this change to each participant based on the time between baseline visit and initial MRI visit assuming linear change in PFF over time. Multivariable-adjusted proportional hazards models tested associations of pPFF with incident chronic kidney disease (CKD), cardiovascular disease (CVD) and death.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Participants had a mean\u00a0\u00b1\u00a0standard deviation age of 56\u00a0\u00b1\u00a08\u00a0years, mean eGFR of 98\u00a0\u00b1\u00a013\u00a0mL\/min\/1.73 m2, median (IQR) albuminuria of 5.7 (3.5\u20139.2) mg\/g and median pPFF of 4.7 (1.6\u201310.3)%. During median follow-up of 13.8\u00a0years, there were 572 incident CKD, 1048 incident CVD and 468 death events. In final adjusted models, participants in the 4th, 3rd and 2nd quartiles had 1.58-, 1.42- and 1.76-fold higher risks of incident CKD compared with the 1st quartile, respectively. Participants in the 4th quartile had 1.27-fold higher risk of incident CVD compared with the lowest quartile. The associations of pPFF with incident CKD and CVD were each non-linear (each P\u00a0&amp;lt;\u00a0.001). pPFF was not associated with death.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Higher pPFF levels are associated with higher risk of incident CKD and CVD but not death. Future studies should investigate whether pancreas fat depots should serve as a target of current or emerging therapies.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/ckj\/sfaf310","type":"journal-article","created":{"date-parts":[[2025,10,9]],"date-time":"2025-10-09T12:10:00Z","timestamp":1760011800000},"source":"Crossref","is-referenced-by-count":3,"title":["Association of pancreas fat fraction with adverse kidney and cardiovascular outcomes"],"prefix":"10.1093","volume":"18","author":[{"given":"Philip","family":"Thomas","sequence":"first","affiliation":[{"name":"University of Illinois Chicago Division of Nephrology, Department of Medicine, , Chicago, IL ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Martina","family":"Salud","sequence":"additional","affiliation":[{"name":"John H. 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