FIB-4 Index and Diabetes Mellitus Are Associated with Chronic Kidney Disease in Japanese Patients with Non-Alcoholic Fatty Liver Disease

Non-alcoholic fatty liver disease (NAFLD) is associated with chronic kidney disease (CKD). The aim of this retrospective study was to determine the risk factors for progression of CKD in patients with biopsy-proven NAFLD including patatin-like phospholipase domain containing 3 (PNPLA3) polymorphism. A total of 344 patients with biopsy-proven NAFLD were enrolled consecutively in this study. Multivariate analysis identified males (odds ratio (OR) 5.46), age (per 1 year, OR 1.07), and FIB-4 index (≥1.30, OR 3.85) as factors associated with CKD. Of the 154 patients with a baseline estimated glomerular filtration rate (eGFR) ≥60 mL/min, 30 had a deterioration in CKD stage and 15 developed CKD after 3 years. Multivariate analysis identified diabetes mellitus (OR 2.44) as a risk factor for deterioration in CKD stage, while diabetes mellitus (OR 21.54) and baseline eGFR (per 1 mL/min OR 0.88) were risk factors for development of CKD. PNPLA3 did not affect the change in eGFR. In NAFLD patients, a high FIB-4 index was associated with CKD to increases in the index linked to reductions in eGFR. In order to prevent development of CKD, an appropriate therapy focusing on renal function is needed for NAFLD patients, especially those with diabetes.

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Non-alcoholic fatty liver disease is associated with increased risk of chronic kidney disease

Therapeutic Advances in Chronic Disease ◽

10.1177/20406223211024361 ◽

2021 ◽

Vol 12 ◽

pp. 204062232110243

Author(s):

Xiaoyan Cai ◽

Lichang Sun ◽

Xiong Liu ◽

Hailan Zhu ◽

Yang Zhang ◽

...

Keyword(s):

Risk Factors ◽

Chronic Kidney Disease ◽

Liver Disease ◽

Kidney Disease ◽

Cohort Studies ◽

Fatty Liver ◽

Fatty Liver Disease ◽

Alcoholic Fatty Liver ◽

Increased Risk ◽

Alcoholic Fatty Liver Disease

Background and Aims: Whether non-alcoholic fatty liver disease (NAFLD) is associated with an increased risk of incident chronic kidney disease (CKD) independent of established cardio-renal risk factors remains controversial. We aimed to provide a quantitative estimate of the association and strength between NAFLD and risk of CKD after adjustment for multiple cardio-renal risk factors. Methods: We searched electronic databases (PubMed, Embase, and Google Scholar) for studies published from database inception until 30 November 2020. Analysis included cohort studies that reported multivariable-adjusted risk ratios [including odds ratios, relative risks (RRs), or hazard ratios] and 95% confidence intervals (CIs) for CKD of NAFLD compared with individuals without NAFLD. Results: A total of 11 cohort studies were included comprising 1,198,242 participants (46.3% women) for analysis. The median follow-up duration was 3.7 years, with 31,922 cases of incident CKD. Compared with individuals without NAFLD, unadjusted models showed that NAFLD was associated with a higher risk of CKD (RR 1.54, 95% CI 1.38–1.71). After adjusting for multiple cardio-renal risk factors, the CKD risk was still significantly increased in patients with NAFLD (RR 1.39, 95% CI 1.27–1.52). Compared with individuals without NAFLD, the adjusted absolute risk increase in NAFLD for CKD was 5.1 (95% CI 3.5–6.8) per 1000 person-years. Conclusion: NAFLD is associated with an increased risk of incident CKD independent of established cardio-renal risk factors.

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Association between Non-Alcoholic Fatty Liver Disease and Chronic Kidney Disease: A Cross-Sectional Study

Journal of Clinical Medicine ◽

10.3390/jcm9061635 ◽

2020 ◽

Vol 9 (6) ◽

pp. 1635

Author(s):

Takemi Akahane ◽

Manabu Akahane ◽

Tadashi Namisaki ◽

Kosuke Kaji ◽

Kei Moriya ◽

...

Keyword(s):

Risk Factors ◽

Chronic Kidney Disease ◽

Liver Disease ◽

Kidney Disease ◽

Fatty Liver ◽

Fatty Liver Disease ◽

Alcoholic Fatty Liver ◽

Common Risk Factors ◽

Obesity Hypertension ◽

Alcoholic Fatty Liver Disease

It is unclear whether the link between non-alcoholic fatty liver disease (NAFLD) and chronic kidney disease (CKD) is mediated by common risk factors. We aimed to elucidate the association between NAFLD and CKD using propensity score (PS)-matched analysis. We assessed 3725 Japanese individuals, excluding those with hepatitis B or C infection and men and women who consumed >30 and >20 g/day of alcohol, respectively. Of these, we enrolled 1097 Japanese subjects with NAFLD diagnosed by ultrasonography and 1097 PS-matched subjects without NAFLD. The prevalence of CKD was higher in subjects with NAFLD than in those without NAFLD before PS matching, but there was no significant difference between these groups in terms of CKD prevalence after PS matching. There was no difference in the prevalence of CKD between those with and without NAFLD in the subgroup analyses. Logistic regression analysis demonstrated that obesity, hypertension, and hyperuricemia were independent predictors of CKD, but NAFLD was not independently associated with CKD. In subjects with NAFLD, obesity, hypertension, and hyperuricemia were independent predictors of CKD. Thus, the link between NAFLD and CKD may be mediated by common risk factors. We recommend screening for CKD when patients with NAFLD have the aforementioned comorbidities.

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Have we learnt all from Improve-It? Part I. Core results and subanalyses on the effects of ezetimibe added to statin therapy related to age, gender and selected chronic diseases (kidney disease, diabetes mellitus and non- alcoholic fatty liver disease)

Current Vascular Pharmacology ◽

10.2174/1570161118999200727224946 ◽

2020 ◽

Vol 18 ◽

Author(s):

Zlatko Fras ◽

Dimitri P. Mikhailidis

Keyword(s):

Diabetes Mellitus ◽

Liver Disease ◽

High Risk ◽

Kidney Disease ◽

Fatty Liver ◽

Fatty Liver Disease ◽

Alcoholic Fatty Liver ◽

Risk Patients ◽

Very High ◽

Alcoholic Fatty Liver Disease

: IMPROVE-IT (IMProved Reduction of Outcomes: Vytorin Efficacy International Trial) was a randomized clini- cal trial (18,144 patients) that evaluated the efficacy of the combination of ezetimibe with simvastatin vs simvastatin mono- therapy in patients with acute coronary syndrome (ACS) and moderately increased low-density lipoprotein cholesterol (LDL-C) levels (of up to 2.6-3.2 mmol/L; 100-120 mg/dL). After 7 years of follow-up, combination therapy resulted in an additional LDL-C decrease [1.8 mmol/L, or 70 mg/dL, within the simvastatin (40 mg/day) monotherapy arm and 1.4 mmol/L, or 53 mg/dL for simvastatin (40 mg/day) + ezetimibe (10 mg/day)] and showed an incremental clinical benefit (composite of cardiovascular death, nonfatal myocardial infarction, unstable angina requiring rehospitalization, coronary re- vascularization (≥30 days after randomization), or nonfatal stroke; hazard ratio (HR) of 0.936, and 95% CI 0.887-0.996, p=0.016). Therefore, for very high cardiovascular risk patients “even lower is even better” regarding LDL-C, independently of the LDL-C reducing strategy. These findings confirm ezetimibe as an option to treat very-high-risk patients who cannot achieve LDL-C targets with statin monotherapy. Additional analyses of the IMPROVE-IT (both prespecified and post-hoc) include specific very-high-risk subgroups of patients (those with previous acute events and/or coronary revascularization, older than 75 years, as well as patients with diabetes mellitus, chronic kidney disease or non-alcoholic fatty liver disease). The data from IMPROVE-IT also provide reassurance regarding longer-term safety and efficacy of the intensification of li- pid-lowering therapy in very-high-risk patients resulting in very low LDL-C levels. We comment on the results of several (sub) analyses of IMPROVE-IT.

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11. Risk factors for development of diabetes mellitus in non-alcoholic fatty liver disease (NAFLD) patients

Journal of Clinical and Experimental Hepatology ◽

10.1016/j.jceh.2018.06.341 ◽

2018 ◽

Vol 8 ◽

pp. S39-S40

Author(s):

Shivaram Prasad Singh ◽

Saroj Kanta Sahu ◽

Prasanta Kumar Parida ◽

Sambit Kumar Behera ◽

Suryakanta Parida ◽

...

Keyword(s):

Diabetes Mellitus ◽

Risk Factors ◽

Liver Disease ◽

Fatty Liver ◽

Fatty Liver Disease ◽

Alcoholic Fatty Liver ◽

Alcoholic Fatty Liver Disease

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Non-alcoholic fatty liver disease and chronic kidney disease

Romanian Medical Journal ◽

10.37897/rmj.2020.s.15 ◽

2020 ◽

Vol 67 (S) ◽

pp. 54-57

Author(s):

Flaviu BOB ◽

Keyword(s):

Chronic Kidney Disease ◽

Liver Disease ◽

Kidney Disease ◽

Fatty Liver ◽

Fatty Liver Disease ◽

Alcoholic Fatty Liver ◽

Alcoholic Fatty Liver Disease

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SP334HIGH PREVALENCE OF NON-ALCOHOLIC FATTY LIVER DISEASE IN CHRONIC KIDNEY DISEASE

Nephrology Dialysis Transplantation ◽

10.1093/ndt/gfx146.sp334 ◽

2017 ◽

Vol 32 (suppl_3) ◽

pp. iii221-iii222

Author(s):

Rajkumar Chinnadurai ◽

Diana Vassallo ◽

James Ritchie ◽

Darren Green ◽

Philip Kalra

Keyword(s):

Chronic Kidney Disease ◽

Liver Disease ◽

Kidney Disease ◽

Fatty Liver ◽

Fatty Liver Disease ◽

Alcoholic Fatty Liver ◽

Alcoholic Fatty Liver Disease

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Systematic review of the impact of non-alcoholic fatty liver disease on mortality and adverse clinical outcomes for individuals with chronic kidney disease

BMJ Open ◽

10.1136/bmjopen-2020-040970 ◽

2020 ◽

Vol 10 (9) ◽

pp. e040970 ◽

Cited By ~ 1

Author(s):

Theresa Hydes ◽

Ryan Buchanan ◽

Oliver J Kennedy ◽

Simon Fraser ◽

Julie Parkes ◽

...

Keyword(s):

Systematic Review ◽

Chronic Kidney Disease ◽

Liver Disease ◽

Kidney Disease ◽

Fatty Liver ◽

Clinical Outcomes ◽

Fatty Liver Disease ◽

Alcoholic Fatty Liver ◽

All Cause Mortality ◽

Alcoholic Fatty Liver Disease

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.

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