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. 2024 Dec 1;5(12):1844-1852.
doi: 10.34067/KID.0000000569. Epub 2024 Sep 5.

Investigating the Association between Steatotic Liver Disease and CKD in a Nationally Representative Sample

Mason Lai  1 , Jennifer C Lai  1 , Andrew S Allegretti  2 , Kavish R Patidar  3   4 , Giuseppe Cullaro  1
Affiliations

Investigating the Association between Steatotic Liver Disease and CKD in a Nationally Representative Sample

Mason Lai et al. Kidney360. .

Abstract

Key Points:

  1. CKD is more common among those with steatotic liver disease compared with those without liver disease in the United States.

  2. Higher degrees of liver fibrosis are associated with greater prevalence of CKD independent of other common risk factors of kidney disease.

Background: Steatotic liver disease (SLD) and CKD are common conditions that are strongly associated. Yet, there is a paucity of data regarding the prevalence of this overlap and the factors that may drive its occurrence.

Methods: Using the National Health and Nutrition Examination Survey, we examined trends among adult participants from 2005 to 2020 that defined SLD using the Fatty Liver Index. We completed correlative analyses among adult participants from 2017 to 2020 that defined SLD on the basis of FibroScan results. We used multivariable survey-weighted binomial generalized linear models to determine the factors that were associated with CKD, defined as eGFR <60 or urine albumin-creatinine ratio >30.

Results: Among the 76,496 participants included in

trend analyses, the estimated prevalence of CKD was 15.7% (95% confidence interval [CI], 15.2% to 16.2%) and SLD was 42.3% (95% CI, 41.4% to 43.2%). As compared with those without SLD, those with SLD had a significantly higher estimated prevalence of CKD (SLD, 15.7%; 95% CI, 14.9% to 16.5%; versus no SLD, 11.2%; 95% CI, 10.7% to 11.7%). In multivariate analyses of 3667 participants who underwent FibroScan and had SLD defined using the Fatty Liver Index, adjusting for control and presence of diabetes mellitus, hypertension, and hyperlipidemia/dyslipidemia, compared with those with normal liver stiffness, those with moderate scarring (F2) had similar odds of CKD (1.53; 95% CI, 0.91 to 2.56), those with severe scarring (F3) had higher odds of CKD (2.28; 95% CI, 1.20 to 4.32), and those with cirrhosis had higher odds of CKD (2.21; 95% CI, 1.13 to 4.32).

Conclusions: Our findings highlight that CKD is common among patients with SLD and that higher degrees of hepatic fibrosis are associated with CKD independent of other comorbidities of the metabolic syndrome.

Trial registration: ClinicalTrials.gov NCT04483947.

PubMed Disclaimer

Conflict of interest statement

Disclosure forms, as provided by each author, are available with the online version of the article at http://links.lww.com/KN9/A664.

Figures

None
Graphical abstract
Figure 1
Figure 1
Prevalence of CKD in the United States by SLD and fibrosis category from 2005 to March 2020. SLD, steatotic liver disease.
Figure 2
Figure 2
Prevalence of CKD in the United States and SLD, fibrosis category, and diabetes from 2005 to March 2020. DM, diabetes mellitus.
Figure 3
Figure 3
Prevalence of CKD in the United States and SLD, fibrosis category, and HTN from 2005 to March 2020. HTN, hypertension.
Figure 4
Figure 4
Prevalence of CKD in the United States and SLD, fibrosis category, and dyslipidemia from 2005 to March 2020. HLD, hyperlipidemia/dyslipidemia.
See this image and copyright information in PMC

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