Diabetic CKD Linked to Fatty Liver Disease

This article originally appeared here.
NAFLD strongly tied to risk of incident CKD, independent of traditional risk factors.
NAFLD strongly tied to risk of incident CKD, independent of traditional risk factors.

For patients with type 1 diabetes, nonalcoholic fatty liver disease (NAFLD) is independently associated with the risk of incident chronic kidney disease (CKD), according to a study published in Diabetes Care.

Giovanni Targher, M.D., from the University of Verona in Italy, and colleagues followed 261 adults with type 1 diabetes with preserved kidney function and with no macroalbuminuria at baseline for a mean of 5.2 years for incident CKD. Ultrasonography was used to diagnose NAFLD.

Patients had a mean estimated glomerular filtration rate (eGFR) of 92 ± 23 mL/min/1.73 m² at baseline; 89.7 and 10.3 percent had normoalbuminuria and microalbuminuria, respectively. About half of patients (50.2 percent) had NAFLD. The researchers found that 61 patients developed incident CKD during follow-up. An increased risk of CKD was associated with NAFLD (hazard ratio, 2.85; P < 0.001).

This association was not attenuated appreciably by adjustment for age, sex, duration of diabetes, hypertension, glycated hemoglobin, and baseline eGFR (adjusted hazard ratio, 2.03; P < 0.01). After exclusion of those with microalbuminuria at baseline, the association was still significant (adjusted hazard ratio, 1.85; P < 0.05).

The discriminatory capability of regression models for predicting CKD was significantly improved with addition of NAFLD to traditional CKD risk factors (with NAFLD: c-statistic, 0.79 versus 0.76 without NAFLD; P = 0.002).

"Further large, long-term prospective studies are needed to confirm our results (before suggesting a routine liver ultrasound examination in all patients with type 1 diabetes to better predict the future development of CKD)," the authors write.

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