Incidence and predictors of non-alcoholic fatty liver disease among patients with chronic kidney disease

Triozzi, Jefferson L.; Richardson, Peter; Gregg, L. Parker; Navaneethan, Sankar D.

doi:10.1093/ndt/gfab046

Cited by 6 publications

(6 citation statements)

References 15 publications

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“…This new Asian modified CKD-EPI equation may allow for more accurate GFR estimates in Chinese CKD patients in practice, especially in higher GFR populations. CKD was defined as eGFR < 60 mL/min/1.73 m 2 for 90 days ( 27 ).…”

Section: Methodsmentioning

confidence: 99%

“…A recent retrospective cohort study in the United States found that the incidence of NAFLD in CKD patients (eGFR < 60 mL/min/1.73 m 2 for 90 days) was 4.4%. And the incidence of the CKD3a stage is higher than the CKD3b-5 stages ( 27 ). Another study found a high prevalence of NAFLD (56%) observed in non-diabetic CKD patients receiving hemodialysis and pre-dialysis CKD patients ( 28 ).…”

Section: Introductionmentioning

confidence: 99%

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Evaluated Glomerular Filtration Rate Is Associated With Non-alcoholic Fatty Liver Disease: A 5-Year Longitudinal Cohort Study in Chinese Non-obese People

et al. 2022

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ObjectiveEvidence regarding the association between evaluated glomerular filtration rate (eGFR) and non-alcoholic fatty liver disease (NAFLD) is still limited. On that account, the purpose of our research is to survey the link of evaluated eGFR on NAFLD.MethodsThis study is a retrospective cohort study. Which consecutively and non-selectively collected a total of 16,138 non-obese participants in a Chinese hospital from January 2010 to December 2014. We then used the Cox proportional-hazards regression model to explore the relationship between baseline eGFR and NAFLD risk. A Cox proportional hazards regression with cubic spline functions and smooth curve fitting (the cubic spline smoothing) was used to identify the non-linear relationship between eGFR and NAFLD. Additionally, we also performed a series of sensitivity analyses and subgroup analyses. Data had been uploaded to the DATADRYAD website.ResultsThe mean age of the included individuals was 43.21 ± 14.95 years old, and 8,467 (52.47%) were male. The mean baseline eGFR was 98.83 ± 22.80 mL/min per 1.73m2. During a median follow-up time of 35.8 months, 2,317 (14.36%) people experienced NAFLD. After adjusting covariates, the results showed that eGFR was negatively associated with incident NAFLD (HR = 0.983, 95%CI: 0.980, 0.985). There was also a non-linear relationship between eGFR and NAFLD, and the inflection point of eGFR was 103.489 mL/min per 1.73 m2. The effect sizes (HR) on the left and right sides of the inflection point were 0.988 (0.984, 0.991) and 0.971 (0.963, 0.979), respectively. And the sensitive analysis demonstrated the robustness of our results. Subgroup analysis showed that eGFR was more strongly associated with incident NAFLD in diastolic blood pressure (DBP) < 90 mmHg, fasting plasma glucose (FPG) ≤ 6.1 mmol/L, high-density lipoprotein cholesterol (HDL-c) < 1 mmol/L, and alanine aminotransferase (ALT) ≥ 40 U/L participants. In contrast, the weaker association was probed in those with DBP ≥ 90 mmHg, ALT < 40 U/L, FPG > 6.1 mmol/L, and HDL-c ≥ 1 mmol/L.ConclusionThis study demonstrates a negative and non-linear association between eGFR and incident NAFLD in the Chinese non-obese population. eGFR is strongly related to NAFLD when eGFR is above 103 mL/min per 1.73 m2. From a therapeutic perspective, it makes sense to maintain eGFR levels within the inflection point to 130 mL/min/1.73 m2.

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Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Evaluated Glomerular Filtration Rate Is Associated With Non-alcoholic Fatty Liver Disease: A 5-Year Longitudinal Cohort Study in Chinese Non-obese People

et al. 2022

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“…With this new Asian CKD-EPI equation, more accurate GFR estimates for Chinese patients with CKD may be possible, particularly in populations with higher GFRs. CKD was defined as eGFR < 60 mL/min/1.73 m 2 for 90 days ( 22 ).…”

Section: Methodsmentioning

confidence: 99%

“…There are many common risk factors associated with NAFLD and CKD, including obesity, dyslipidemia, diabetes, and hypertension ( 21 ). The incidence of NAFLD in CKD patients was 4.4%, according to a retrospective cohort study conducted in the United States ( 22 ). Another recent research, which included 2,600 Chinese patients with NAFLD and diabetes, found that there was a greater likelihood of liver fibrosis with a lower eGFR ( 23 ).…”

Section: Introductionmentioning

confidence: 99%

Triglyceride affects the association between estimated glomerular filtration rate and the onset of non-alcoholic fatty liver disease: A second analysis of a Chinese cohort study

Cao²,

Han³

et al. 2022

Front. Med.

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ObjectiveThe role of triglyceride (TG) and estimated glomerular filtration rate (eGFR) effect modifiers on the risk of non-alcoholic fatty liver disease (NAFLD) is unknown. This study examined whether TG modifies the relationship between eGFR and incident NAFLD.MethodsIn a Chinese hospital from January 2010 to December 2014, 15,555 non-obese subjects were collected systematically for this retrospective cohort study. The target-independent and dependent variables were eGFR measured at baseline and NAFLD appearing during follow-up. The modified variable was TG measured at baseline. The multivariate Cox proportional hazards model was used to explore eGFR and TG’s association with NAFLD risk. We explored a priori interaction between eGFR and TG, and performed subgroup analyses to further assess whether the relationship between eGFR and incident NAFLD was modified by TG. We also explored the effect of TG and eGFR interaction on the risk of NAFLD.ResultsThe mean age was 43.09 ± 14.92 years, and 8,131 (52.27%) were males. During a median follow-up time of 35.8 months, 2,077 (13.35%) individuals developed NAFLD. In the adjusted model, eGFR was negatively associated with incident NAFLD (HR = 0.984, 95% CI: 0.982, 0.987), while TG was positively related to NAFLD (HR = 1.582, 95% CI: 1.490, 1.681). TG could modify the relationship between eGFR and incident NAFLD. A stronger association between eGFR and NAFLD could be found in the participants without hypertriglyceridemia (HTG) (HR = 0.981, 95% CI: 0.978–0.984, P for interaction = 0.0139). In contrast, the weaker association was probed in the population with HTG (HR = 0.986, 95% CI: 0.983–0.989). At the same time, we also found an interaction between eGFR and TG in influencing NAFLD risk. In participants with decreased eGFR and HTG, the risk of NAFLD was significantly increased. Further, compared to non-HTG subjects with eGFR ≥ 116.56 ml/min/1.73 m2, participants with HTG and eGFR < 82.88 ml/min/1.73 m2 had about a fourfold increase in the risk (HR = 4.852 95% CI: 3.943–5.970) of NAFLD.ConclusioneGFR and TG is independently associated with NAFLD risk. The association of eGFR with incident NAFLD is likely to be modified by TG in the Chinese non-obese population. There was an interactive effect between eGFR and TG in affecting NAFLD risk. In participants with decreased eGFR and hypertriglyceridemia, the risk of NAFLD is significantly increased.

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“…Также предполагается, что НАЖБП и ХБП могут быть связаны посредством патологической активации ренин-ангиотензиновой системы, компоненты которой экспрессируются как клетками печени (гепатоцитами и звездчатыми клетками), так и клетками почек (клетками канальцев и клубочкового аппарата) [17]. Данное предположение перекликается с результатом ряда работ, которые показывают снижение риска развития НАЖБП у больных ХБП, получающих ингибиторы ангиотензин-превращающего фермента [18]. Существуют данные, подтверждающие ассоциацию фиброза печени с патологической активацией ренин-ангиотензиновой системы.…”

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Chronic kidney disease and non-alcoholic fatty liver disease - new pathogenetic links

Krasner

Осипенко

Холин

et al. 2023

jour

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This article discusses the association between non-alcoholic fatty liver disease (NAFLD) and chronic kidney disease (CKD). There is ample evidence of an increased risk of CKD in patients with NAFLD. Most researchers attribute to the common risk factors for these two conditions. Currently, in addition to traditional factors associated with CKD and NAFLD, such as components of the metabolic syndrome, the influence of new pathogenetic factors, i. e. endothelial dysfunction, metabolic disorders of fibroblast growth factor-21, pathological activation of the renin-angiotensin system and influence of adiponectin level change are considered. Further examination of these mechanisms will open up new therapeutic options for the treatment of CKD and NAFLD.

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Incidence and predictors of non-alcoholic fatty liver disease among patients with chronic kidney disease

Cited by 6 publications

References 15 publications

Evaluated Glomerular Filtration Rate Is Associated With Non-alcoholic Fatty Liver Disease: A 5-Year Longitudinal Cohort Study in Chinese Non-obese People

Evaluated Glomerular Filtration Rate Is Associated With Non-alcoholic Fatty Liver Disease: A 5-Year Longitudinal Cohort Study in Chinese Non-obese People

Triglyceride affects the association between estimated glomerular filtration rate and the onset of non-alcoholic fatty liver disease: A second analysis of a Chinese cohort study

Chronic kidney disease and non-alcoholic fatty liver disease - new pathogenetic links

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