Patients with nonalcoholic fatty liver disease (NAFLD) are at increased risk of developing advanced chronic kidney disease (CKD), according to researchers.

Among 262,619 patients newly diagnosed with NAFLD and 769,878 patients without NAFLD in the United States matched by age, gender, comorbidities, and calendar year, 5766 and 8655, respectively, developed stage 3 to 5 CKD. The crude CKD incidence rate was higher in the patients with than without NAFLD: 8.2 vs 5.5 per 1000 person-years, Haesuk Park, PhD, of the University of Florida College of Pharmacy in Gainesville, and colleagues reported in the Journal of Internal Medicine. In a multivariable Cox model, patients with NAFLD had a significant 1.4-fold higher risk of developing advanced CKD than patients without the condition after adjusting for demographics and the use of angiotensin-converting enzyme inhibitors and angiotensin-receptor blockers. The association held in sensitivity analyses.

CKD risk rose along with NAFLD severity. Patients with compensated and decompensated cirrhosis had significant 1.5- and 2.3-fold increased risks of advanced CKD, respectively, compared with the no-NAFLD group. The team also identified several other CKD risk factors including age older than 60 years, male gender, congestive heart failure, diabetes, hypertension, and obesity.  

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“Our findings suggest that patients with NAFLD should be screened for CKD, to be monitored regularly for renal function, and to receive early interventions to potentially decrease the risk of CKD, especially those are at high risk of developing incident CKD such as older or male patients and those with diabetes, hypertension, heart failure, and cirrhosis,” Dr Park and colleagues stated.

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Park H, Dawwas GK, Liu X, Nguyen MH. Nonalcoholic fatty liver disease increases risk of incident advanced chronic kidney disease: a propensity-matched cohort study [published July 29, 2019]. J Intern Med. doi: 10.1111/joim.12964