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

Publication Title

Hepatobiliary & Pancreatic Diseases International

Divisions

fac_med

Funders

Gilead Sciences (IN -US- 989-5334)

Volume

23

Issue

3

Publisher

Elsevier

Publisher Location

RADARWEG 29, 1043 NX AMSTERDAM, NETHERLANDS

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