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. 2022 Jun 23;23(13):7007. doi: 10.3390/ijms23137007

Table 1.

Main systematic reviews and meta-analyses assessing the association between non-alcoholic fatty liver disease (NAFLD) and risk of incident chronic kidney disease (CKD).

Reference Study Characteristics Definition of NAFLD Definition of CKD Main Results
[26] Systematic review and
meta-analyses of 33
observational studies (20 cross-sectional ones and 13 longitudinal ones) for a total of 63,902 individuals		 Liver enzymes,
ultrasonography and liver biopsy		 One or more of the following criteria:

  • eGFR < 60 mL/min/1.73 m2

  • ACR ≥ 30 mg/g

  • Morning dipstick proteinuria ≥1

  • NAFLD was associated with a higher risk of prevalent (random effects OR 2.12, 95% CI 1.69-2.66) and incident (random effects HR 1.79, 95% CI 1.65–1.95) CKD

  • NASH was associated with a higher risk of prevalent (random effects OR 2.53, 95% CI 1.58–4.05) and incident (random effects HR 2.12, 95% CI 1.42–3.17) CKD than simple steatosis

  • Advanced fibrosis was associated with a higher prevalent (random effects OR 5.20, 95% CI 3.14–8.61) and incident (random effects HR 3.29, 95% CI 2.30–4.71) CKD than non-advanced fibrosis
[27] Systematic review and
meta-analyses of nine
longitudinal studies for a total of 96,595 individuals (34.1% with NAFLD). Median
follow-up: 5.2 years		 Liver enzymes, fatty liver index and
ultrasonography		 eGFR < 60 mL/min/1.73 m2 and/or overt proteinuria

  • NAFLD was associated with a higher risk of incident CKD (random effects HR 1.37, 95% CI 1.20–1.53)

  • More severe NAFLD (defined as a high-intermediate NAFLD fibrosis score or elevated serum GGT levels among individuals with ultrasound-diagnosed NAFLD) was associated with a higher risk of incident CKD (random effects HR 1.50, 95% CI 1.25–1.74)
[9] Systematic review and
meta-analyses of 13
longitudinal studies
(with a follow-up duration of ≥1 year) for a total of 1,222,032 individuals (28.1% with NAFLD). Median follow-up: 9.7 years		 Liver enzymes, fatty liver index, imaging techniques, ICD-9 codes, and liver
biopsy

  • eGFR < 60 mL/min/1.73 m2 and/or overt proteinuria

  • CKD stage ≥ 3 identified by the ICD-9 codes

  • NAFLD was associated with a higher risk of incident CKD (random effects HR 1.43, 95%  CI 1.33 to 1.54)

Abbreviations: ACR, albumin-to-creatinine ratio; CI, confidence interval; CKD, chronic kidney disease; eGFR, estimated glomerular filtration rate; FLI, fatty liver index, HR, hazard ratio; ICD, International Classification of Diseases; NAFLD, non-alcoholic fatty liver disease; NASH, non-alcoholic steatohepatitis; OR odds ratio.