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. 2020 Jul:222:127-133.
doi: 10.1016/j.jpeds.2020.03.038. Epub 2020 May 4.

Glomerular Hyperfiltration Is Associated with Liver Disease Severity in Children with Nonalcoholic Fatty Liver Disease

Toshifumi Yodoshi  1 , Ana Catalina Arce-Clachar  2 , Qin Sun  3 , Lin Fei  4 , Kristin Bramlage  1 , Stavra A Xanthakos  2 , Francisco Flores  5 , Marialena Mouzaki  6
Affiliations

Glomerular Hyperfiltration Is Associated with Liver Disease Severity in Children with Nonalcoholic Fatty Liver Disease

Toshifumi Yodoshi et al. J Pediatr. 2020 Jul.

Abstract

Objectives: To determine the prevalence of renal impairment in a large cohort of youths with histologically confirmed nonalcoholic fatty liver disease (NAFLD), and to determine its association with liver disease severity.

Study design: Clinical, laboratory, and histology data were collected retrospectively in a pediatric cohort with biopsy-confirmed NAFLD at a tertiary care center between 2010 and 2017. Histological NAFLD severity was scored using validated criteria. Glomerular filtration rate (GFR) was calculated and categorized as low (<90 mL/min/1.73 m2), normal (90-136 mL/min/1.73 m2), or high (>136 mL/min/1.73 m2). Univariate and multivariate modeling were used to determine differences between the GFR groups and to control for confounders.

Results: The cohort comprised 179 patients (82% non-Hispanic; median age; 14 years; IQR, 12-16 years). One-third of the patients had abnormal renal function, including 36 (20%) with glomerular hyperfiltration and 26 (15%) with low GFR. In multivariable logistic regression, compared with normal GFR, hyperfiltration was independently associated with higher NAFLD activity score (aOR, 2.96; 95% CI, 1.49-5.87; P = .002), after adjusting for age, sex, ethnicity, obesity severity, presence of type 2 diabetes mellitus, and medications.

Conclusions: In this large cohort with histologically confirmed NAFLD, renal impairment was highly prevalent and associated with liver disease severity, independent of obesity severity. Screening patients with confirmed NAFLD for renal complication is recommended.

Keywords: glomerular hyperfiltration; hepatic steatosis; renal impairment.

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Conflict of interest statement

The authors declare no conflicts of interest.

Figures

Figure.
Figure.
Relationship between median GFR categories and NAS in the study cohort.
See this image and copyright information in PMC

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