Format

Send to

Choose Destination
Sci Rep. 2018 Mar 16;8(1):4718. doi: 10.1038/s41598-018-23014-0.

Nonalcoholic fatty liver disease accelerates kidney function decline in patients with chronic kidney disease: a cohort study.

Author information

1
Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Kangbuk Samsung Hospital, Seoul, South Korea.
2
Department of Clinical Research Design and Evaluation, SAIHST, Sungkyunkwan University, Kangbuk Samsung Hospital, Seoul, South Korea.
3
Center for Clinical Epidemiology, Samsung Medical Center, Sungkyunkwan University, Kangbuk Samsung Hospital, Seoul, South Korea.
4
Center for Health Promotion, Samsung Medical Center, Kangbuk Samsung Hospital, Seoul, South Korea.
5
Department of Clinical Pharmacology and Therapeutics, Samsung Medical Center, Samsung Biomedical Research Institute, Sungkyunkwan University School of Medicine, Kangbuk Samsung Hospital, Seoul, South Korea.
6
Center for Total Health Studies, Kangbuk Samsung Hospital, Seoul, South Korea.
7
Division of Nephrology, Department of Medicine, Johns Hopkins University School of Medicine, Johns Hopkins Medical Institutions, Baltimore, Maryland, USA.
8
Departments of Epidemiology and Medicine and Welch Center for Prevention, Epidemiology and Clinical Research, Johns Hopkins Medical Institutions, Baltimore, Maryland, USA.
9
Department of Clinical Research Design and Evaluation, SAIHST, Sungkyunkwan University, Kangbuk Samsung Hospital, Seoul, South Korea. jcho@skku.edu.
10
Center for Clinical Epidemiology, Samsung Medical Center, Sungkyunkwan University, Kangbuk Samsung Hospital, Seoul, South Korea. jcho@skku.edu.
11
Departments of Epidemiology and Medicine and Welch Center for Prevention, Epidemiology and Clinical Research, Johns Hopkins Medical Institutions, Baltimore, Maryland, USA. jcho@skku.edu.
12
Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Kangbuk Samsung Hospital, Seoul, South Korea. gy.gwak@samsung.com.

Abstract

This study aimed to investigate the association of nonalcoholic fatty liver disease (NAFLD) and its severity with the decline in kidney function in patients with chronic kidney disease (CKD). We conducted a cohort study of 1,525 CKD patients who underwent repeated health check-up examinations from January 2003 through December 2013. NAFLD was diagnosed by ultrasonography and its severity was assessed by the NAFLD fibrosis score. At baseline, the prevalence of NAFLD was 40.9%, and the mean estimated glomerular filtration rate (eGFR) was 59.1 ml/min/1.73 m2. The average follow-up was 6.5 years. The age- and sex-adjusted decline in eGFR was greater in patients with NAFLD (-0.79% per year, 95% CI -1.31%, -0.27%) compared to those without it (0.30%, 95% CI -0.14%, 0.76%; p = 0.002). In multivariable adjusted models, the average difference in annual percent change in decline in eGFR comparing patients with NAFLD to those without NAFLD was -1.06% (-1.73%, -0.38%; p = 0.002). The decline in eGFR associated with NAFLD was greater in patients with higher NAFLD fibrosis score, in those with proteinuria or with low eGFR at baseline ( <45 ml/min/1.73 m2), and in those who were smokers and hypertensive. Therefore, NAFLD is independently associated with CKD progression.

Supplemental Content

Full text links

Icon for Nature Publishing Group Icon for PubMed Central
Loading ...
Support Center