Prevalence and risk factors for impaired renal function among Asian patients with nonalcoholic fatty liver disease
Document Type
Article
Publication Date
6-1-2024
Abstract
Background: Nonalcoholic fatty liver disease (NAFLD) is associated with impaired renal function, and both diseases often occur alongside other metabolic disorders. However, the prevalence and risk factors for impaired renal function in patients with NAFLD remain unclear. The objective of this study was to identify the prevalence and risk factors for renal impairment in NAFLD patients. Methods: All adults aged 18-70 years with ultrasound-diagnosed NAFLD and transient elastography examination from eight Asian centers were enrolled in this prospective study. Liver fibrosis and cirrhosis were assessed by FibroScan-aspartate aminotransferase (FAST), Agile 3 + and Agile 4 scores. Impaired renal function and chronic kidney disease (CKD) were defined by an estimated glomerular filtration rate (eGFR) with value of < 90 mL/min/1.73 m(2) and < 60 mL/min/1.73 m(2) , respectively, as estimated by the CKD-Epidemiology Collaboration (CKD-EPI) equation. Results: Among 529 included NAFLD patients, the prevalence rates of impaired renal function and CKD were 37.4% and 4.9%, respectively. In multivariate analysis, a moderate-high risk of advanced liver fibrosis and cirrhosis according to Agile 3 + and Agile 4 scores were independent risk factors for CKD ( P < 0.05). Furthermore, increased fasting plasma glucose (FPG) and blood pressure were significantly associated with impaired renal function after controlling for the other components of metabolic syndrome ( P < 0.05). Compared with patients with normoglycemia, those with prediabetes FPG >= 5.6 mmol/L or hemoglobin A1c (HbA1c) >= 5.7%] were more likely to have impaired renal function ( P < 0.05). Conclusions: Agile 3 + and Agile 4 are reliable for identifying NAFLD patients with high risk of CKD. Early glycemic control in the prediabetic stage might have a potential renoprotective role in these patients. (c) 2023 First Affiliated Hospital, Zhejiang University School of Medicine in China. Published by Elsevier B.V. All rights reserved.
Keywords
Nonalcoholic fatty liver disease, Impaired renal function, Agile 3+, Agile 4, Metabolic syndrome
Divisions
fac_med
Funders
Gilead Sciences (IN -US- 989-5334)
Publication Title
Hepatobiliary & Pancreatic Diseases International
Volume
23
Issue
3
Publisher
Elsevier
Publisher Location
RADARWEG 29, 1043 NX AMSTERDAM, NETHERLANDS