Table 1.
Studies examining the risk of developing chronic kidney disease (CKD) among patients with non-alcoholic fatty liver disease (NAFLD).
| Author, Year of Publication |
Study Population | Country | Diagnosis of NAFLD | Results |
|---|---|---|---|---|
| Retrospective studies | ||||
| Yun et al., 2009 [12] | 37,085 healthy subjects who underwent health examinations | Korea | Serum ALT > 40 IU/L (patients with hepatitis B or C, or alcoholic liver disease were excluded) |
ALT > 40 IU/L group had a significantly higher creatinine level than ALT < 40 IU/L group (0.9 mg/dL vs. 0.8 mg/dL). |
| Targher et al., 2010 [13] | 80 patients with biopy-proven NASH and 80 control subjects matched for age, sex, and BMI | Italy | Histological | NASH was independently associated with an increased prevalence of CKD (25% vs. 3.7%). Adjusted OR, 6.14 (95% CI, 1.60–12.8). |
| Yasui et al., 2011 [14] | 174 patients with biopsy-proven NAFLD | Japan | Histological | Prevalence of CKD was significantly higher among NASH group (21%) than among simple steatosis group (6%). Adjusted OR, 2.46 (p = 0.11; not significant because of dependency on hypertension) |
| Sirota et al., 2012 [15] | 11,469 volunteers who participated in the National Health and Nutrition Examination Survey (NHANES 1988–1994) | United States | Ultrasonography (other chronic liver disease were excluded) | NAFLD was not associated with the prevalence of CKD after adjustment for components of metabolic syndrome. |
| Sinn et al., 2017 [16] | 41,430 adult men and women without CKD at baseline who underwent repeated health check-up examinations | Korea | Ultrasonography | NAFLD was associated with an increased risk of CKD development. Adjusted HR, 1.22 (95% CI, 1.04–1.43). The risk of CKD increased progressively with increases in the NAFLD fibrosis score. |
| Park et al., 2019 [17] | 262,619 newly diagnosed patients with NAFLD and 769,878 propensity score (1:3)-matched non-NAFLD patients from the Truven Health MarketScan Database (2006–2015) | United States | Ultrasonography | Patients with NAFLD had a 41% increased risk of developing advanced (stages 3–5) CKD compared with non-NAFLD patients. Adjusted HR, 1.41 (95% CI, 1.36–1.46). |
| Prospective studies | ||||
| Chang et al., 2008 [18] | 8329 healthy male volunteers with normal baseline kidney functions (Follow-up duration: 3.2 years) |
Korea | Ultrasonography | NAFLD was independently associated with the development of CKD. Adjusted relative risk, 1.55. |
| Targher et al., 2008 [19] | 2103 patiens with type 2 diabetes mellitus | Italy | Ultrasonography | NAFLD was associated with increased risk of CKD (OR, 1.87) independently of age, sex, BMI, hypertension, diabetes duration, HbA1c, or LDL-cholesterol. |
ALT: Alanine aminotransferase, NAFLD: Non-alcoholic fatty liver disease, NASH: Non-alcoholic steatohepatitis, BMI: Body mass index, CKD: chronic kidney disease, OR: Odds ratio, CI: Confidence interval, HR: Hazard ratio, HbA1c: Hemoglobin A1c, LDL: Low-density lipoprotein.