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. 2021 Nov 9:12:20406223211048649.
doi: 10.1177/20406223211048649. eCollection 2021.

The association between NAFLD and risk of chronic kidney disease: a cross-sectional study

Ying Cao  1 , You Deng  1 , Jingjing Wang  1 , Hong Zhao  1 , Jingyu Zhang  1 , Wen Xie  2
Affiliations

The association between NAFLD and risk of chronic kidney disease: a cross-sectional study

Ying Cao et al. Ther Adv Chronic Dis. .

Abstract

Objective: The aim of this study was to evaluate the association between nonalcoholic fatty liver disease (NAFLD) and NAFLD with different comorbidities and risk of chronic kidney disease (CKD) and abnormal albuminuria.

Materials and methods: A total of 3872 Chinese individuals excluding those with hepatitis B or C infection and absence of alcohol abuse were included in the study. NAFLD was diagnosed by abdominal ultrasonography. The liver fibrosis was assessed by NAFLD fibrosis score (NFS) and fibrosis-4 index (FIB-4). CKD was defined as an estimated glomerular filtration rate (eGFR) < 60 ml/min/1.73 m2 and/or abnormal albuminuria (urinary albumin-to-creatinine ratio ⩾ 3 mg/mmol). The logistic regression analysis was performed to examine the association between NAFLD and NAFLD with different comorbidities and risk of CKD.

Results: The prevalence of CKD and abnormal albuminuria was higher in individuals with NAFLD than in those without NAFLD (15.8% vs 11.9%, p < 0.001; 14.8% vs 11.0%, p < 0.001). Logistic regression analysis demonstrated that NAFLD was risk factor of CKD. Notably, after adjustment for sex, age, and DM, NAFLD was associated with 1.31-fold higher risk of prevalent CKD ⩾ 1 (p < 0.05). NAFLD individuals with elder age, DM, obesity, hypertension, MetS, and advanced liver fibrosis had higher risks of both prevalent CKD and abnormal albuminuria than those without comorbidities.

Conclusions: NAFLD and NAFLD with traditional comorbidities are strongly associated with risk of prevalence of CKD and abnormal albuminuria. Patients with NAFLD especially those with coexisting comorbidities were recommended to carefully access the development of CKD.

Keywords: CKD; NAFLD; liver fibrosis.

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Conflict of interest statement

Conflict of interest statement: The authors declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Figures

Figure 1.
Figure 1.
Comparison of prevalence of CKD (panel a) and presence of abnormal albuminuria (panel b) between subjects with non-NAFLD, NAFLD, and NAFLD with difference comorbidities. *p < 0.05; **p < 0.01; ***p < 0.001. #p < 0.05; ##p < 0.01; ###p < 0.001. *Value of p for non-NAFLD comparison. #Value of p for NAFLD comparison.
Figure 2.
Figure 2.
Odds ratios for prevalent CKD comparing participants with NAFLD with those without NAFLD in different subgroups.
Figure 3.
Figure 3.
Odds ratios for abnormal albuminuria (increased ACR) comparing participants with NAFLD with those without NAFLD in different subgroups.
Figure 4.
Figure 4.
Comparison of prevalence of CKD (panel a, c) and presence of abnormal albuminuria (panel b, d) between subjects with NAFLD and those without NAFLD stratified by NAFLD fibrosis score (NFS) and Fibrosis 4 score (FIB-4). *Value of p for compare with non-NAFLD, p < 0.05. #Value of p compared with NFS < −1.455 or FIB-4 < 1.3, p < 0.05. $Value of p for compare with −1.455 ⩽ NFS < 0.676 or 2.67 ⩽ FIB-4 < 1.3, p < 0.05.
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