Abstract
Aims/hypothesis: Non-alcoholic fatty liver disease (NAFLD) and chronic kidney disease (CKD) are progressive chronic conditions that share important cardiometabolic risk factors and pathogenic mechanisms. We investigated the association between liver fibrosis measured by transient elastography (TE) and the risk of incident CKD in individuals with NAFLD. Methods: A total of 5983 participants with NAFLD (defined as controlled attenuation parameter >222 dB/m) but without CKD who underwent TE between March 2012 and August 2018 were selected. The primary outcome was incident CKD, defined as the occurrence of eGFR <60 ml min−1 [1.73 m]−2 or proteinuria (≥1+ on dipstick test) on two consecutive measurements during follow-up. The secondary outcome was a 25% decline in eGFR measured on two consecutive visits. Results: The mean age was 51.8 years and 3756 (62.8%) participants were male. During 17,801 person-years of follow-up (mean follow-up of 3.0 years), 62 participants (1.0%) developed incident CKD. When stratified into TE-defined fibrosis stages (F0–F4), multivariable Cox models revealed that risk of incident CKD was 5.40-fold (95% CI 2.46, 11.84; p < 0.001) higher in the F3/F4 group (≥9.5 kPa) than in the F0 group (<5.5 kPa). During 17,577 person-years of follow-up (mean follow-up of 3.0 years), 201 participants (3.4%) experienced the secondary outcome, for which the F3/F4 group had a 3.22-fold higher risk (95% CI 1.96, 5.28; p < 0.001) than the F0 group. Conclusions/interpretation: In this large cohort of individuals with NAFLD but without baseline CKD, advanced liver fibrosis measured by TE was significantly associated with a higher risk of incident CKD. Graphical abstract: [Figure not available: see fulltext.].
| Original language | English |
|---|---|
| Pages (from-to) | 518-527 |
| Number of pages | 10 |
| Journal | Diabetologia |
| Volume | 65 |
| Issue number | 3 |
| DOIs | |
| Publication status | Published - 2022 Mar |
Bibliographical note
Funding Information:This study was supported by Basic Science Research Program through the National Research Foundation of Korea (NRF) funded by the Ministry of Science, ICT & Future Planning (2019R1A2C4070136). The funders had no role in study design, data collection and analysis, decision to publish or preparation of the manuscript.
Funding Information:
SUK has served as an advisory committee member for Gilead Sciences, Bayer, Eisai and Novo Nordisk and is a speaker for Gilead Sciences, GSK, Bayer, Eisai, AbbVie, EchoSens, MSD, Eisai, Otsuka and Bristol-Myers Squibb. SUK has also received a research grant from AbbVie and Bristol-Myers Squibb. The other authors declare that there are no relationships or activities that might bias, or be perceived to bias, their work.
Funding Information:
The authors thank the Medical Illustration & Design team of the Medical Research Support Services of Yonsei University College of Medicine for all artistic support related to this work. SUK has served as an advisory committee member for Gilead Sciences, Bayer, Eisai and Novo Nordisk and is a speaker for Gilead Sciences, GSK, Bayer, Eisai, AbbVie, EchoSens, MSD, Eisai, Otsuka and Bristol-Myers Squibb. SUK has also received a research grant from AbbVie and Bristol-Myers Squibb. The other authors declare that there are no relationships or activities that might bias, or be perceived to bias, their work.
Publisher Copyright:
© 2021, The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.
All Science Journal Classification (ASJC) codes
- Internal Medicine
- Endocrinology, Diabetes and Metabolism
