BACKGROUND/AIMS: Nonalcoholic fatty liver disease (NAFLD) has been proposed to contribute to chronic kidney disease (CKD) independently of traditional cardiometabolic risk factors. We hypothesized that NAFLD is associated with CKD and that greater severity of NAFLD is associated with higher odds of CKD. METHODS: A cross-sectional analysis of 11,469 adults who participated in the National Health and Nutrition Examination Survey (NHANES) 1988-1994. NAFLD was defined by ultrasonographic detection of steatosis in the absence of other liver diseases. CKD was defined as an estimated glomerular filtration rate of ≤60 ml/min/1.73 m(2) or the presence of albuminuria in subjects with an estimated glomerular filtration rate of >60 ml/min/1.73 m(2). RESULTS: 2,891 (25.4%) patients in the cohort had CKD. The prevalence of NAFLD was higher in individuals with CKD compared to those without CKD (42.2 vs. 34.5%, p < 0.0001). NAFLD was associated with CKD in unadjusted logistic regression analysis (OR = 1.47, 95% CI: 1.29-1.67, p < 0.0001). Adjustment for demographics and components of metabolic syndrome attenuated this relationship (OR = 1.04, 95% CI: 0.88-1.23, p = 0.64). Moderate and severe NAFLD on ultrasound were increasingly associated with prevalent CKD in unadjusted analysis, but not after adjustment for metabolic syndrome components. CONCLUSION: After adjusting for features of metabolic syndrome, ultrasound-diagnosed NAFLD is not associated with prevalent CKD among US adults. Aggressive public health efforts are needed to prevent and treat metabolic syndrome.
BACKGROUND/AIMS: Nonalcoholic fatty liver disease (NAFLD) has been proposed to contribute to chronic kidney disease (CKD) independently of traditional cardiometabolic risk factors. We hypothesized that NAFLD is associated with CKD and that greater severity of NAFLD is associated with higher odds of CKD. METHODS: A cross-sectional analysis of 11,469 adults who participated in the National Health and Nutrition Examination Survey (NHANES) 1988-1994. NAFLD was defined by ultrasonographic detection of steatosis in the absence of other liver diseases. CKD was defined as an estimated glomerular filtration rate of ≤60 ml/min/1.73 m(2) or the presence of albuminuria in subjects with an estimated glomerular filtration rate of >60 ml/min/1.73 m(2). RESULTS: 2,891 (25.4%) patients in the cohort had CKD. The prevalence of NAFLD was higher in individuals with CKD compared to those without CKD (42.2 vs. 34.5%, p < 0.0001). NAFLD was associated with CKD in unadjusted logistic regression analysis (OR = 1.47, 95% CI: 1.29-1.67, p < 0.0001). Adjustment for demographics and components of metabolic syndrome attenuated this relationship (OR = 1.04, 95% CI: 0.88-1.23, p = 0.64). Moderate and severe NAFLD on ultrasound were increasingly associated with prevalent CKD in unadjusted analysis, but not after adjustment for metabolic syndrome components. CONCLUSION: After adjusting for features of metabolic syndrome, ultrasound-diagnosed NAFLD is not associated with prevalent CKD among US adults. Aggressive public health efforts are needed to prevent and treat metabolic syndrome.
Authors: Caroline S Fox; Martin G Larson; Eric P Leip; Bruce Culleton; Peter W F Wilson; Daniel Levy Journal: JAMA Date: 2004-02-18 Impact factor: 56.272
Authors: Robert M Wilechansky; Alison Pedley; Joseph M Massaro; Udo Hoffmann; Emelia J Benjamin; Michelle T Long Journal: Liver Int Date: 2019-05-24 Impact factor: 5.828
Authors: Ravi V Shah; Matthew A Allison; Joao A C Lima; Siddique A Abbasi; Morgana Mongraw-Chaffin; Michael Jerosch-Herold; Jingzhong Ding; Matthew J Budoff; Venkatesh L Murthy Journal: J Nephrol Date: 2015-02-25 Impact factor: 3.902
Authors: Giovanni Musso; Roberto Gambino; James H Tabibian; Mattias Ekstedt; Stergios Kechagias; Masahide Hamaguchi; Rolf Hultcrantz; Hannes Hagström; Seung Kew Yoon; Phunchai Charatcharoenwitthaya; Jacob George; Francisco Barrera; Svanhildur Hafliðadóttir; Einar Stefan Björnsson; Matthew J Armstrong; Laurence J Hopkins; Xin Gao; Sven Francque; An Verrijken; Yusuf Yilmaz; Keith D Lindor; Michael Charlton; Robin Haring; Markus M Lerch; Rainer Rettig; Henry Völzke; Seungho Ryu; Guolin Li; Linda L Wong; Mariana Machado; Helena Cortez-Pinto; Kohichiroh Yasui; Maurizio Cassader Journal: PLoS Med Date: 2014-07-22 Impact factor: 11.069