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

Abstract

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.

Keywords: chronic kidney disease; comorbidity; hepatic steatosis; hypertension; hyperuricemia; non-alcoholic fatty liver disease; obesity.

Figure 1

The prevalence of CKD in the subgroup analyses stratified by non-NAFLD and NAFLD. (a) Comparison of the prevalence of CKD between non-obese and obese subjects; (b) comparison of the prevalence of CKD between subjects with and without hypertension; (c) comparison of the prevalence of CKD between subjects with and without hyperuricemia. CKD, chronic kidney disease; NAFLD, non-alcoholic fatty liver disease.