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To explore the association of renal surface nodularity (RSN) with the increased adverse vascular event (AVE) risk in patients with arterial hypertension. This cross-sectional study included patients with arterial hypertension aged 18–60 years who underwent contrasted computed tomography (CT) of kidney from January 2012 to December 2020. The subjects were classified into AVE or not (non-AVE) matched with age (≤5 years) and sex. Their CT images were analyzed using both qualitative (semiRSN) and quantitative RSN (qRSN) methods, respectively. Their clinical characteristics included age, sex, systolic blood pressure (SBP), diastolic blood pressure, hypertension course, diabetes history, hyperlipidemia, and estimated glomerular filtration rate (eGFR). Compared with non-AVE group ( n  = 91), AVE ( n  = 91) was at lower age, higher SBP, and fewer rate of diabetes and hyperlipidemia history (all  P  &lt; .01). Rate of positive semiRSN was higher in AVE than non-AVE (49.45% vs 14.29%,  P  &lt; .001). qRSN was larger in AVE than non-AVE [1.03 (0.85, 1.33) vs 0.86 (0.75,1.03),  P  &lt; .001]. The increased AVE was associated with semiRSN (odds ratio = 7.04,  P  &lt; .001) and qRSN (odds ratio = 5.09,  P  = .003), respectively. For distinguishing AVE from non-AVE, the area under receiver operating characteristic was bigger in the models combining the clinical characteristics with either semiRSN or qRSN than that of semiRSN or qRSN alone ( P  ≤.01). Among the patients with arterial hypertension aged 18–60 years, CT imaging-based RSN was associated with increased AVE risk.

Association between renal surface nodularity and increased adverse vascular event risk in patients with arterial hypertension