scholarly journals SP278IMPACT OF NON-ALCOHOLIC FATTY LIVER DISEASE ON CARDIOVASCULAR OUTCOMES AND MORTALITY IN ADVANCED CHRONIC KIDNEY DISEASE

2017 ◽  
Vol 32 (suppl_3) ◽  
pp. iii200-iii200
Author(s):  
Rajkumar Chinnadurai ◽  
James Ritchie ◽  
Diana Vassallo ◽  
Darren Green ◽  
Philip Kalra
2017 ◽  
Vol 32 (suppl_3) ◽  
pp. iii221-iii222
Author(s):  
Rajkumar Chinnadurai ◽  
Diana Vassallo ◽  
James Ritchie ◽  
Darren Green ◽  
Philip Kalra

BMJ Open ◽  
2020 ◽  
Vol 10 (9) ◽  
pp. e040970 ◽  
Author(s):  
Theresa Hydes ◽  
Ryan Buchanan ◽  
Oliver J Kennedy ◽  
Simon Fraser ◽  
Julie Parkes ◽  
...  

ObjectivesTo investigate if non-alcoholic fatty liver disease (NAFLD) impacts mortality and adverse outcomes for individuals with chronic kidney disease (CKD).DesignSystematic review.Data sourcesPubMed, EMBASE and Web of Science were searched up to 1 February 2020 with no restriction on the earliest date.Eligibility criteria for selecting studiesObservational cohort studies that reported either the risk of all-cause mortality, incidence of non-fatal cardiovascular events (CVE) or progression of kidney disease among adults with established CKD who have NAFLD compared with those without.Data extraction and synthesisTwo reviewers extracted data and assessed bias independently.ResultsOf 2604 records identified, 3 studies were included (UK (n=852), South Korea (n=1525) and USA (n=1413)). All were judged to have a low or moderate risk of bias. Data were insufficient for meta-analysis. Two studies examined the influence of NAFLD on all-cause mortality. One reported a significant positive association for NAFLD with all-cause mortality for individuals with CKD (p<0.05) (cardiovascular-related mortality p=ns), which was lost following adjustment for metabolic risk factors; the second reported no effect in adjusted and unadjusted models. The latter was the only study to report outcomes for non-fatal CVEs and observed NAFLD to be an independent risk factor for this (propensity-matched HR=2.00, p=0.02). Two studies examined CKD progression; in one adjusted rate of percentage decline in estimated glomerular filtration rate per year was found to be increased in those with NAFLD (p=0.002), whereas the other found no significant difference.ConclusionsFew studies have examined the influence of NAFLD on prognosis and major adverse clinical outcomes within the CKD population. The studies identified were diverse in design and results were conflicting. This should be a focus for future research as both conditions continue to rise in prevalence and have end-stage events associated with significant health and economic costs.PROSPERO registration numberCRD42020166508.


2013 ◽  
Vol 34 (3) ◽  
pp. 199 ◽  
Author(s):  
Ah-Leum Ahn ◽  
Jae-Kyung Choi ◽  
Mi-Na Kim ◽  
Seun-Ah Kim ◽  
Eun-Jung Oh ◽  
...  

2021 ◽  
Vol 6 (3) ◽  
pp. 148-155
Author(s):  
A. A. Antoniv ◽  
◽  
O. S. Khukhlina ◽  
Z. Ya. Kotsiubiychuk ◽  
V. V. Vivsyannuk ◽  
...  

The purpose of the study was to find out the probable mutual influence of the state of the lipid spectrum of blood and content of adipokines in blood: leptin, adiponectin on the clinical course of non-alcoholic fatty liver disease against the background of obesity depending on its form and the presence of comorbid chronic kidney disease. Materials and methods. 444 patients were examined: of which 84 patients with non-alcoholic fatty liver disease with grade I obesity (group 1), which contained 2 subgroups: 32 patients with non-alcoholic hepatic steatosis and 52 patients with non-alcoholic steatohepatitis; 270 patients with non-alcoholic fatty liver disease with comorbid obesity of the I degree and chronic kidney disease of the I-III stage (group 2), including 110 patients with non-alcoholic steatosis of the liver and 160 patients with non-alcoholic steatohepatitis. The control group consisted of 90 patients with chronic kidney disease stage I-III with normal body weight (group 3). The mean age of patients was (45.8±3.81) years. Results and discussion. The study showed that patients with non-alcoholic steatohepatitis and obesity without concomitant chronic kidney disease are characterized by the following changes in the blood lipid spectrum: maximum increase in blood triacylglycerols (by 2.1 times, p <0.05), a probable increase in total cholesterol (by 1.4 times, p <0.05) and proatherogenic low-density lipoproteins (by 1.6 times, p <0.05), a probable decrease in anti-atherogenic high-density lipoproteins (by 1.6 times, p <0.05), which with the addition of comorbid chronic kidney disease are likely to deepen (within 1.5-1.8 times, p <0.05), in addition to hyper triacylglycerol. According to the results of the study, the content of leptin in the blood was significantly increased by 1.4 times (p <0.05) compared with almost healthy individuals, which differed significantly from patients with non-alcoholic steatosis of the liver with chronic kidney disease and non-alcoholic steatohepatitis with chronic kidney disease (p <0.05). The content of adiponectin in the blood was significantly reduced by 1.4 times compared with almost healthy individuals (p <0.05) and also differed significantly from patients with non-alcoholic hepatic steatosis with chronic kidney disease and non-alcoholic steatohepatitis with chronic kidney disease (p <0.05). Conclusion. Based on the results, it was found that significant metabolic prerequisites for the development of non-alcoholic steatohepatitis against the background of obesity and chronic kidney disease are probable postprandial hyperglycemia, hyperinsulinemia, increased glycosylation of hemoglobin. Hyperleptinemia and hypoadiponectinemia are also factors in the burden of non-alcoholic steatohepatitis and obesity due to the progression of mesenchymal inflammation and cytolysis of hepatocytes


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