Non-alcoholic Fatty Liver Disease and Chronic Kidney Disease in Koreans Aged 50 Years or Older

Abstract

BackgroundNon-alcoholic fatty liver disease (NAFLD) and chronic kidney disease (CKD) share common pathogenic mechanisms and many risk factors, and both are linked to an increased risk of cardiovascular diseases. The aim of this study was to assess the association between NAFLD and CKD according to the presence of hypertension and diabetes mellitus in Koreans aged 50 years or older.MethodsA cross-sectional study of 1,706 subjects who received their routine health examination was conducted between May 2008 and April 2010 at Konkuk University medical center. Biochemical tests for liver and abdominal ultrasonography were performed. CKD was defined as either proteinuria or glomerular filtration rate ≤60 mL/min per 1.73 m2.ResultsAmong the 1,706 subjects, There were 545 (31.9%) with non-alcoholic fatty liver disease and 424 (24.9%) with chronic kidney disease. In univariate logistic regression analysis, NAFLD was significantly associated with CKD (odds ratio [OR], 1.69; 95% confidence interval [CI], 1.34 to 2.12). In multivariate logistic regression analysis adjusted for age, sex, current smoking, abdominal obesity, aspartate aminotransferases, alanine aminotransferases, γ-glutamyltransferase, hypertension, diabetes mellitus, hypertriglyceridemia, and low high-density lipoprotein cholesterol, NAFLD was associated with CKD (adjusted OR, 1.68; 95% CI, 1.27 to 2.24). This relationship remained significant after classification according to the presence of hypertension or diabetes mellitus.ConclusionNAFLD diagnosed by ultrasonography was significantly associated with CKD in Koreans aged 50 years or older.

Relations of liver fat with prevalent and incident chronic kidney disease in the Framingham Heart Study: A secondary analysis

“…Individuals with NAFLD can progress to develop cirrhosis and hepatocellular carcinoma and are also at risk for extrahepatic diseases including diabetes mellitus and cardiovascular disease . Further, emerging evidence suggests NAFLD may be associated with chronic kidney disease (CKD) . CKD represents a substantial disease burden in the United States, affecting approximately 8% of the population, and the incidence is increasing in parallel to obesity .…”

“…Hepatic steatosis has been associated with CKD in a number of prior cross‐sectional and longitudinal studies, though results are conflicting . Recent meta‐analyses have concluded that NAFLD was associated with an increased risk of prevalent and incident CKD, and the severity of liver disease positively correlated with advancing CKD .…”

Non-alcoholic fatty liver disease: an emerging driving force in chronic kidney disease

“…In the last 5 years, a number of cross-sectional community-based and hospital-based studies have consistently demonstrated that NAFLD, as diagnosed either by imaging [16][17][18][19][20][21][22][23][24] or by histology [25][26][27][28][29] , is associated with an increased prevalence of CKD (defined as presence of decreased estimated glomerular filtration rate [eGFR] or abnormal albuminuria or overt proteinuria) in patients with NAFLD. In these studies, the prevalence of CKD in patients with NAFLD ranged from approximately 20% to 55% compared to 5%-30% in those without NAFLD [16][17][18][19][20][21][22][23][24][25][26][27][28][29] .…”

“…In these studies, the prevalence of CKD in patients with NAFLD ranged from approximately 20% to 55% compared to 5%-30% in those without NAFLD [16][17][18][19][20][21][22][23][24][25][26][27][28][29] . Notably, in most of these studies the association between NAFLD and CKD was independent of common cardio-renal risk factors across a wide range of patient populations.…”

Impact of Co-Morbidities in Non Alcoholic Fatty Liver Disease among Type 2 Diabetes Mellitus

“…Because of study population heterogeneity, and differences in NAFLD diagnostic features, NAFLD severity, and CKD definition used, the reported prevalence and incidence of CKD are largely conflicting. However, most of the recent large population based andhospital based studies represent that the prevalence and incidence of CKD was greatly increase in subjects with NAFLD [39][40][41][42][43][44]. According to a current metaanalysis,NAFLD was connected with an raised prevalence and incidence of CKD and nonalcoholic steatohepatitis(NASH) was related with a higher prevalenceand incidence of CKD than simple steatosis independent of potential confounding factors including age, smoking, obesity, hypertension, and metabolic syndrome elements [45].…”