NAFLD development, fibrosis progression tied to increased CKD risk

The development of nonalcoholic fatty liver disease (NAFLD) and progression of fibrosis contribute to a higher risk of incident chronic kidney disease (CKD), suggests a recent study.

A community-based prospective study was conducted to assess the relationship of NAFLD status change and fibrosis progression with the risk of incident CKD in participants aged ≥40 years and free of CKD at baseline in 2010. Follow-up evaluations were carried out after a mean of 4.4 years.

The authors diagnosed NAFLD via ultrasonography and used NAFLD fibrosis score (NFS) to assess fibrosis stage and progression. CKD was defined by estimated glomerular filtration rate or urine albumin-to-creatinine ratio. Measurements were done both at baseline and follow-up examination.

A total of 4,042 participants with four NAFLD status change groups were included in the analysis. After adjustments for confounders including evolution of diabetes, hypertension, and obesity, in addition to the baseline levels, Incident NAFLD was found to contribute to an increased risk of incident CKD (odds ratio [OR], 1.44, 95 percent confidence interval [CI], 1.003–2.06; p=0.048).

However, no significant difference was noted in the risk of incident CKD between NAFLD resolution and persistent NAFLD.

In addition, fibrosis progression from low to intermediate or high NFS significantly correlated with a higher risk of incident CKD (OR, 2.82, 95 percent CI, 1.22–6.56; p=0.016), compared with stable fibrosis in low NFS, in 534 participants in the persistent NAFLD group.