Visceral obesity is strongly associated with both cardiovascular and chronic kidney diseases. A potential mechanism by which obesity could promote hypertension and kidney diseases is through accumulation of fat in the renal sinus (RS) (Chughtai, et al. 2010; Foster, et al. 2011). Aim of the study was to evaluate association between CT measured abdominal fat segments, serum renin and blood pressure (BP). The study included 210 subjects (F/M 110/110) aged 37.30 ±4.10yr. CT images were captured and volumetric RS fat, retroperitoneal (RP), intraperitoneal (IP) and subcutaneous (SC) fat volumes were measured at the level of right kidney (RP, IP and SC was segmented according anatomical landmarks published previously) (Chughtai et al. 2010). Fat depots were measured using the 3D-Doctor software. Total volumetric kidney segmentation was performed (we excluded major branches of the renal artery and vein as well as any visible branches of the renal collecting system). In order to exclude the kidney size effect on RS fat volume, ratio of RS fat volume to corresponding total kidney size was calculated for each participant. Serum renin level was detected by xMAP technology. Experimental procedures were approved by the Ethical Committee of the Institute of Experimental and Clinical Medicine, University of Latvia. All procedures performed in this study were in accordance with the ethical standards of the institutional and international research committee and with the 1964 Helsinki declaration. Informed consent was obtained from all (n = 210) study participants. Volumetric CT measurements showed asymmetric RS fat deposition. Left RS accumulate significantly (p<0,001; Wilcoxon Signed Rank test) higher amount of adipose tissue compared to the right RS both for men and women – left RS fat volume (2,76 (1,49 to 4,62) cm3 and 1,39 (0,57 to 2,99) cm3 for men and women, respectively; right RS fat volume 1,07 (0,46 to 2,45) and 0,39 (0,10 to 0,95) for men and women, respectively (nonparametric data, presented as median and interquartile range. Multiple regression (Forward method; Square root (sqrt) transformation was used for skew data; Dependent variable: systolic/diastolic (BP); Independent variable: all abdominal fat segments) revealed that only IP fat volume increase were positively associated with systolic (βmen=0,45; βwomen=0,62 p<0,001) and diastolic (βmen=0,41; βwomen=0,61 p<0,001) BP. Standardized coefficient β significantly increase when sqrt renin were entered in model. Interestingly – renin in this model had inverse effect (decrease of serum level of renin together with increased IP volume ensured systolic BP increase). It has recently been demonstrated that adipocyte angiotensin (ANG) plays a central role in the development of hypertension. Angiotensinogen in adipocytes are converted to ANGI by cathepsin instead of renin (Frigolet, et al. 2013). Additionally, adipocytes secrete aldosterone that can induce sodium retention and BP increase. BP increase due to previously mentioned mechanism possibly inhibit renal renin secretion. These data suggest that RS fat accumulation does not have effect on systolic and diastolic BP in middle-aged subjects. IP fat accumulation show positive association with systolic and diastolic BP increase possible due to adipocyte secreted ANG or aldosterone.