Prevalence of non-alcoholic fatty liver disease among patients with non-diabetic chronic kidney disease detected by transient elastography

Behairy, Maha; Sherief, Ahmed Fouad; Hussein, Hany A.

doi:10.1007/s11255-021-02815-9

Cited by 11 publications

(20 citation statements)

References 26 publications

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“…Our results highlight the importance of the combination of the three risk factors (PNPLA3 genotype, CKD, and FIB-4 index) for early prediction of CVDs in patients with NAFLD. Recent reports show that a high frequency of NAFLD could be observed among the patients with CKD and a possible association of NAFLD with the increase in CVDs among those patients [25]. The present study identified CKD as one risk factor for the incidence of CVDs in patients with NAFLD and agreed to this recent report [25].…”

Section: Factorsupporting

confidence: 92%

“…Recent reports show that a high frequency of NAFLD could be observed among the patients with CKD and a possible association of NAFLD with the increase in CVDs among those patients [25]. The present study identified CKD as one risk factor for the incidence of CVDs in patients with NAFLD and agreed to this recent report [25]. The mechanism of the increase in the CVDs is still unknown in NAFLD patients with CKD.…”

Section: Factorsupporting

confidence: 91%

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PNPLA3 genotype and fibrosis-4 index predict cardiovascular diseases of Japanese patients with histopathologically-confirmed NAFLD

et al. 2021

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Background Reliable noninvasive predictors of the top three causes of death [cardiovascular diseases (CVDs), malignancies, and liver-related events in patients with non-alcoholic fatty liver disease (NAFLD)] have not yet been determined. Methods We retrospectively investigated the incidence of three complications [CVDs, malignancy (except for liver cancer), and liver-related events] in 477 Japanese patients with histo-pathologically confirmed NAFLD for a median follow-up of 5.9 years. In addition to histological findings, we also investigated noninvasive predictors. Results A score of ≥ 2.67 for the noninvasive diagnosis of stage 4 fibrosis based on the Fibrosis-4 (FIB-4) index indicated a high level area under the receiver operating characteristic (AUROC) curve (0.90), sensitivity (82.9%), specificity (86.4%), and negative predictive value [(NPV) of 98.5%]. The yearly incidence rates of CVDs, malignancies, and liver-related events were found to be 1.04%, 0.83%, and 0.30%, respectively. Multivariate analysis identified a FIB-4 index ≥ 2.67 score as a significant and independent, noninvasive predictor of these three complications. Furthermore, the cumulative incidence rates of CVDs were significantly different among the three genotypes of PNPLA3. PNPLA3 genotype CC, chronic kidney disease (CKD), and FIB-4 index ≥ 2.67 was could be attributed to these three significant CVD risk factors. The rates of CVDs were significantly different among the three subgroups based on the combination of risk factors. In malignancy (except for liver cancer), the incidence rate of colon cancer was 25.0%; in particular, the rate in females was 53.8%. Conclusions Our results highlighted the importance of the PNPLA3 genotype and FIB-4 index ≥ 2.67 on the incidence of complications in Japanese patients with NAFLD, especially the incidence of CVDs. Early diagnosis, based on the presence of one or more risk factors, and early treatment might improve the prognosis for NAFLD patients.

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Section: Factorsupporting

confidence: 92%

Section: Factorsupporting

confidence: 91%

PNPLA3 genotype and fibrosis-4 index predict cardiovascular diseases of Japanese patients with histopathologically-confirmed NAFLD

et al. 2021

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“…Baseline study characteristics are outlined in Table 1 . Six studies were performed in East Asia [ 15 , 16 , 20–22 , 28 ], five in Europe [ 14 , 17 , 19 , 25 , 26 ], two in the USA [ 18 , 24 ] and one in North Africa [ 27 ]. One study was multinational [ 23 ].…”

Section: Resultsmentioning

confidence: 99%

“…those with hepatorenal syndrome) have a very poor short-term prognosis without liver transplantation [ 41 ] and may not have survived the minimum period on dialysis to meet study inclusion criteria. This may have led to an underestimation of survival rates in this systematic review, as six studies included in this review considered only patients who had been dialysing for a minimum period of 30 days–6 months [ 15 , 16 , 19 , 23 , 26 , 27 ]. Other studies that abstracted registry data may not have included inpatients initiating dialysis who did not survive to hospital discharge.…”

Section: Discussionmentioning

confidence: 99%

“…Three articles with small sample sizes reported on the prevalence of NAFLD in the dialysis setting and indicated that the prevalence of NAFLD in dialysis patients was greater than that in the general population [ 2 ]. The true prevalence of NAFLD may be even higher in dialysis populations, as two of these three studies excluded patients with obesity and DM [ 26 , 27 ]. It was not possible to establish NAFLD as a risk factor for cardiovascular mortality as part of this study due to insufficient data.…”

Section: Discussionmentioning

confidence: 99%

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Prevalence and outcomes of chronic liver disease in patients receiving dialysis: systematic review and meta-analysis

Swift

Sharma

Ramanarayanan

et al. 2021

Clinical Kidney Journal

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Background Patients receiving dialysis for end-stage kidney disease (ESKD) commonly co-exhibit risk factors for hepatic impairment. This systematic review and meta-analysis aimed to quantify the co-existence of chronic liver disease (CLD) and characterise risk factors and outcomes. Methods We searched the following databases from inception to May 2021: CINAHL, Cochrane Library, EMBASE, Kings Fund Library, MEDLINE and PubMed. The protocol was pre-registered on PROSPERO (study ID: CRD42020206486). Studies were assessed against three inclusion criteria: (1) adults (>18 years) with ESKD receiving dialysis (2) primary outcome involving CLD prevalence (3) publications in English. Moderator analysis was performed for age, gender, study size, and publication year. Sensitivity analysis was performed where applicable by removing outlier results and studies at high risk of bias. Results Searches yielded 7,195 articles, 15 met the inclusion criteria. 320,777 patients were included. Prevalence of cirrhosis and non-alcoholic fatty liver disease (NAFLD) was 5% and 55%, respectively. Individuals with CLD had two-fold higher mortality than those without (OR 2.19; 95% confidence interval 1.39-3.45). Hepatitis B (OR 13.47;1.37-132.55) and hepatitis C (OR 7.05; 4.00-12.45), but not diabetes, conferred increased cirrhosis risk. All studies examining NAFLD were judged to be at high risk of bias. We found no data on non-alcoholic steatohepatitis (NASH). Deaths from CLD, cancer and infection were greater amongst cirrhotic patients. Conclusions CLD is prevalent in dialysis patients. Hepatitis B and C confer increased risk of CLD. The impact of NAFLD and NASH cirrhosis requires further study. CLD associates with increased mortality risk in this setting.

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Association between fatty liver index and risk of end-stage renal disease stratified by kidney function in patients with type 2 diabetes: A nationwide population-based study

Chung

Han

Lee

et al. 2023

Diabetes & Metabolism

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Prevalence of non-alcoholic fatty liver disease among patients with non-diabetic chronic kidney disease detected by transient elastography

Cited by 11 publications

References 26 publications

PNPLA3 genotype and fibrosis-4 index predict cardiovascular diseases of Japanese patients with histopathologically-confirmed NAFLD

PNPLA3 genotype and fibrosis-4 index predict cardiovascular diseases of Japanese patients with histopathologically-confirmed NAFLD

Prevalence and outcomes of chronic liver disease in patients receiving dialysis: systematic review and meta-analysis

Association between fatty liver index and risk of end-stage renal disease stratified by kidney function in patients with type 2 diabetes: A nationwide population-based study

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