Increased mortality in non-alcoholic fatty liver disease with chronic kidney disease is explained by metabolic comorbidities - 29/09/19
, Karl Dreja b, Peter M. Nilsson c, Stefan Lindgren a, cBienvenue sur EM-consulte, la référence des professionnels de santé.
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| pages | 9 |
| Iconographies | 3 |
| Vidéos | 0 |
| Autres | 0 |
Highlights |
• | CKD prevalence is significantly higher in middle-aged and elderly subjects with NAFLD. |
• | Crude mortality is significantly higher in NAFLD patients with long-term CKD. |
• | Metabolic comorbidities, not CKD, contributes to the increased prospective mortality risk. |
Summary |
Background |
There is a close association between non-alcoholic fatty liver disease (NAFLD) and prevalent chronic kidney disease (CKD). Few longitudinal studies exist. No previous study has investigated to what extent CKD affects mortality in biopsy-proven NAFLD. Our aim was to investigate the long-term risk of developing CKD in biopsy-proven NAFLD and its effect on mortality.
Methods |
Patients with biopsy-proven NAFLD diagnosed in 1978-2006 in Malmö, Sweden were included. Estimated glomerular filtration rate (eGFR) at baseline and last follow-up was calculated with the CKD-EPI equation. CKD 3–5 (< 60 mL/min/1.73 m2) was classified as CKD. Hospital medical records were extensively scrutinized from inclusion to endpoint (death or end of 2016). The prevalence of CKD was compared to a control group from the population-based prospective cohort Malmö Preventive Project (MPP).
Results |
120 patients with biopsy-proven NAFLD were included. Mean age was 52.5 years and mean follow-up time 19.5 years. At baseline CKD prevalence in NAFLD was only significantly higher in the highest age group compared to controls (> 55 years, 25% vs. 9.5%, P = 0.003), and no significant difference was seen at follow-up (in total 37.5% vs. 30.8%, P = 0.124). NAFLD patients with long-term CKD had significantly higher crude overall mortality rate than NAFLD patients without CKD (P < 0.001). Regression analyses revealed that this increased mortality risk was explained by an increased prevalence of metabolic comorbidities (including diabetes mellitus), not CKD.
Conclusion |
Mortality risk is significantly increased in NAFLD patients with long-term CKD due to metabolic comorbidities, not influenced by CKD per se.
Le texte complet de cet article est disponible en PDF.Keywords : Chronic kidney disease, Epidemiology, liver cirrhosis, Liver fibrosis, Metabolic syndrome, Mortality, non-alcoholic fatty liver disease
Abbreviations : CKD, CKD-EPI, CVD, eGFR, MPP, MPP-RES, NAFLD, NASH
Plan
Vol 43 - N° 5
P. 542-550 - octobre 2019 Retour au numéro
Article précédent
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