Objective: The study included 11,050 adults who underwent abdominal CT as part of a health check-up and re-evaluated the follow-up medical examination at a university-affiliated healthcare center.  Levels of VAT and SAT were divided into quartiles, and the highest quartile for VAT was set as the cut-off for central obesity. Impact of abdominal adipose tissue and central obesity on CKD development was analyzed separately in the non-obese group (BMI<25) and obese group (BMI≥25). Methods: During the mean of 5.6 follow-up years, 104 incident CKD cases were identified. In multivariable Cox analysis, hazard ratio for CKD progression was significantly increased in 3rd and 4th quartile ranges of VAT (HR 4.84 [1.57-14.98] and 8.49 [2.68-26.93], respectively). In the analysis stratified by BMI, the risk for CKD was increased in the highest quartile range of VAT compared to the lowest in the normal weight group: 7.20 (1.56-33.17). However, there was no significant relationship between VAT and CKD development in the obese group. Compared to normal weight and no central obesity, the HR for CKD was 2.71(1.48-4.96) for normal weight and central obesity and 2.94(1.34-6.46) for obesity and central obesity. Results: Visceral adipose tissue measured by CT proved to be a significant risk factor for subsequent CKD only in the normal-weight group. Normal-weight central obesity had an excessive risk of CKD compared to normal-weight without central obesity, even similar to the risk of obesity and central obesity. Conclusions: Objective: Increase in visceral abdominal adipose tissue is highly related to the subsequent development of chronic kidney disease. We conducted a longitudinal health examination follow-up cohort study to evaluate the impact of visceral abdominal adipose tissue (VAT) and subcutaneous abdominal adipose tissue (SAT) measured by computed tomography(CT) on the risk of CKD development according to BMI, and the impact of central obesity measured by VAT according to BMI status. Methods: The study included 11,050 adults who underwent abdominal CT as part of a health check-up and re-evaluated the follow-up medical examination at a university-affiliated healthcare center.  Levels of VAT and SAT were divided into quartiles, and the highest quartile for VAT was set as the cut-off for central obesity. Impact of abdominal adipose tissue and central obesity on CKD development was analyzed separately in the non-obese group (BMI<25) and obese group (BMI≥25). Results: During the mean of 5.6 follow-up years, 104 incident CKD cases were identified. In multivariable Cox analysis, hazard ratio for CKD progression was significantly increased in 3rd and 4th quartile ranges of VAT (HR 4.84 [1.57-14.98] and 8.49 [2.68-26.93], respectively). In the analysis stratified by BMI, the risk for CKD was increased in the highest quartile range of VAT compared to the lowest in the normal weight group: 7.20 (1.56-33.17). However, there was no significant relationship between VAT and CKD development in the obese group. Compared to normal weight and no central obesity, the HR for CKD was 2.71(1.48-4.96) for normal weight and central obesity and 2.94(1.34-6.46) for obesity and central obesity. Conclusions: Visceral adipose tissue measured by CT proved to be a significant risk factor for subsequent CKD only in the normal-weight group. Normal-weight central obesity had an excessive risk of CKD compared to normal-weight without central obesity, even similar to the risk of obesity and central obesity.