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. 2023 Apr 17;28(1):153.
doi: 10.1186/s40001-023-01114-6.

Non-alcoholic fatty liver disease (NAFLD) is associated with an increased incidence of chronic kidney disease (CKD)

Christoph Roderburg #  1 , Sarah Krieg #  1 , Andreas Krieg  2 , Münevver Demir  3 , Tom Luedde  1 , Karel Kostev #  4 , Sven H Loosen #  5
Affiliations

Non-alcoholic fatty liver disease (NAFLD) is associated with an increased incidence of chronic kidney disease (CKD)

Christoph Roderburg et al. Eur J Med Res. .

Abstract

Background: Non-alcoholic fatty liver disease (NAFLD) is the leading cause of chronic liver disease in the western world. The excess mortality in NAFLD patients is strongly related to extrahepatic comorbidities. Recently, an association between NAFLD and chronic kidney disease (CKD) has been reported in various populations.

Methods: Based on the IQVIA Disease Analyzer database, this retrospective study examined two cohorts from Germany matched for sex, age, index year, annual visit frequency, hypertension, and diabetes, including 92,225 patients with and without NAFLD. The incidence of CKD was assessed as a function of NAFLD using Cox regression models.

Results: A total of 92,225 NAFLD patients as well as 92,225 patients without NAFLD were included into analyses. CKD was diagnosed in 19.1% vs. 11.1% of patients with and without NAFLD within the 10 years observation period (p < 0.001). Cox regression confirmed a significant association between NAFLD and CKD with a hazard ratio (HR) of 1.80 (95%CI: 1.73-1.86, p < 0.001). Subgroup analyses revealed that this association was most pronounced in the age group of 18 to 50 years (HR: 2.13, 95%CI: 1.91-2.37, p < 0.001) and among female NAFLD patients (HR 1.85, 95%CI: 1.76-1.95, p < 0.001).

Conclusions: The results of this study confirm a significantly increased risk of developing CKD in a large, real-world cohort of adult NAFLD patients in Germany. Interdisciplinary care of NAFLD patients, which is currently gaining importance worldwide, should be considered to include systematic measures for prevention and/or early detection of CKD with the aim of minimizing long-term renal complications.

Keywords: CKD; Chronic kidney disease; Epidemiology; Metabolic syndrome; NAFLD; NASH; Non-alcoholic fatty liver disease; Non-alcoholic steatohepatitis.

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Conflict of interest statement

The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
Kaplan–Meier curves for time to CKD diagnosis in patients with and without NAFLD
See this image and copyright information in PMC

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