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Role of non-alcoholic fatty liver disease in the evolution of renal function in patients with diabetes mellitus

Role of non-alcoholic fatty liver disease in the evolution of renal function in patients with... BackgroundThe increasing prevalence of type 2 diabetes mellitus (T2DM) has influenced in an increasing prevalence of chronic kidney disease (CKD). Little is known about the influence of non-alcoholic fatty liver disease (NAFLD) on the progression of CKD. The aim of this study was to analyse the role of NAFLD and its severity in the progression of renal function in patients with T2DM.MethodsWe conducted a retrospective and observational study including patients with T2DM and estimated glomerular filtration rate (eGFR) >30 mL/min/1.73 m2. NAFLD was defined as the presence of compatible ultrasonography and/or the presence of fibrosis using the NAFLD score. Patients were classified into three groups according to the NAFLD score: Group 1: <−1.85; Group 2: −1.85–0.18 and Group 3: >0.18.ResultsA total of 102 patients were included [67.6% males, median age 59 years [interquartile range (IQR) 53–64)], with a median time of T2DM evolution of 70 months (IQR 39–131). Group 3 had lower eGFR (84.8 ± 40.4 versus 71.4 ± 30.6 mL/min/1.73 m2; P = 0.03) and higher proteinuria at baseline (0.56 ± 0.77 versus 1.59 ± 2.70 g/24 h; P = 0.05). After a follow-up time of 75.8 ± 23.9 months, Group 3 had a significant decrease in eGFR (66.6 ± 33.3 versus 36.8 ± 23.1 mL/min/1.73 m2; P ≤ 0.01) and a higher risk of CKD progression [odds ratio 7.50 (95% confidence interval 2.76–20.35); P ≤ 0.001] defined as a decrease in eGFR of >50%.ConclusionsThe presence of NAFLD with high-risk fibrosis confers higher risk of CKD progression in patients with T2DM. Therefore NAFLD should be a risk factor evaluated in these patients to optimize treatment. http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Nephrology Dialysis Transplantation Oxford University Press

Role of non-alcoholic fatty liver disease in the evolution of renal function in patients with diabetes mellitus

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References (34)

Publisher
Oxford University Press
Copyright
© The Author(s) 2021. Published by Oxford University Press on behalf of ERA-EDTA.
ISSN
0931-0509
eISSN
1460-2385
DOI
10.1093/ndt/gfab176
Publisher site
See Article on Publisher Site

Abstract

BackgroundThe increasing prevalence of type 2 diabetes mellitus (T2DM) has influenced in an increasing prevalence of chronic kidney disease (CKD). Little is known about the influence of non-alcoholic fatty liver disease (NAFLD) on the progression of CKD. The aim of this study was to analyse the role of NAFLD and its severity in the progression of renal function in patients with T2DM.MethodsWe conducted a retrospective and observational study including patients with T2DM and estimated glomerular filtration rate (eGFR) >30 mL/min/1.73 m2. NAFLD was defined as the presence of compatible ultrasonography and/or the presence of fibrosis using the NAFLD score. Patients were classified into three groups according to the NAFLD score: Group 1: <−1.85; Group 2: −1.85–0.18 and Group 3: >0.18.ResultsA total of 102 patients were included [67.6% males, median age 59 years [interquartile range (IQR) 53–64)], with a median time of T2DM evolution of 70 months (IQR 39–131). Group 3 had lower eGFR (84.8 ± 40.4 versus 71.4 ± 30.6 mL/min/1.73 m2; P = 0.03) and higher proteinuria at baseline (0.56 ± 0.77 versus 1.59 ± 2.70 g/24 h; P = 0.05). After a follow-up time of 75.8 ± 23.9 months, Group 3 had a significant decrease in eGFR (66.6 ± 33.3 versus 36.8 ± 23.1 mL/min/1.73 m2; P ≤ 0.01) and a higher risk of CKD progression [odds ratio 7.50 (95% confidence interval 2.76–20.35); P ≤ 0.001] defined as a decrease in eGFR of >50%.ConclusionsThe presence of NAFLD with high-risk fibrosis confers higher risk of CKD progression in patients with T2DM. Therefore NAFLD should be a risk factor evaluated in these patients to optimize treatment.

Journal

Nephrology Dialysis Transplantation – Oxford University Press

Published: May 13, 2021

Keywords: chronic renal insufficiency; diabetes mellitus; diabetic kidney disease; non-alcoholic fatty liver disease; obesity

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