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Non-alcoholic fatty liver disease and risk of incident chronic kidney disease: an updated meta-analysis.
Gut. 2022 01; 71(1):156-162.Gut

Abstract

OBJECTIVE

Studies reported a significant association between non-alcoholic fatty liver disease (NAFLD) and increased risk of chronic kidney disease (CKD). However, whether this risk changes with increasing severity of NAFLD remains uncertain. We performed a meta-analysis of observational studies to quantify the magnitude of the association between NAFLD and risk of incident CKD.

DESIGN

We systematically searched PubMed, Web of Science and Scopus from January 2000 to August 2020 using predefined keywords to identify observational studies with a follow-up duration of ≥1 year, in which NAFLD was diagnosed by blood biomarkers/scores, International Classification of Diseases codes, imaging techniques or biopsy. Data from selected studies were extracted, and meta-analysis was performed using random-effects modelling.

RESULTS

13 studies with 1 222 032 individuals (28.1% with NAFLD) and 33 840 cases of incident CKD stage ≥3 (defined as estimated glomerular filtration rate <60 mL/min/1.73 m2, with or without accompanying overt proteinuria) over a median follow-up of 9.7 years were included. NAFLD was associated with a moderately increased risk of incident CKD (n=10 studies; random-effects HR 1.43, 95% CI 1.33 to 1.54; I2 =60.7%). All risks were independent of age, sex, obesity, hypertension, diabetes and other conventional CKD risk factors. Sensitivity analyses did not alter these findings. Funnel plot did not reveal any significant publication bias.

CONCLUSION

This large and updated meta-analysis indicates that NAFLD is significantly associated with a~1.45-fold increased long-term risk of incident CKD stage ≥3. Further studies are needed to examine the association between the severity of NAFLD and risk of incident CKD.

Authors+Show Affiliations

Endocrinology and Metabolism, University of Verona Department of Medicine, Verona, Veneto, Italy.Endocrinology and Metabolism, University of Verona Department of Medicine, Verona, Veneto, Italy.Endocrinology and Metabolism, University of Verona Department of Medicine, Verona, Veneto, Italy.Endocrinology and Metabolism, University of Verona Department of Medicine, Verona, Veneto, Italy.Internal Medicine, University of Modena and Reggio Emilia Faculty of Medicine and Surgery, Modena, Emilia-Romagna, Italy.Department of Internal Medicine I, University Medical Center Mainz Department of Internal Medicine 1, Mainz, Rheinland-Pfalz, Germany.Department of Internal Medicine I, Gastroenterology, Hepatology, Endocrinology & Metabolism, University of Innsbruck, Innsbruck, Tirol, Austria.University of Southampton Faculty of Medicine, Southampton, Southampton, UK.Endocrinology and Metabolism, University of Verona Department of Medicine, Verona, Veneto, Italy giovanni.targher@univr.it.

Pub Type(s)

Journal Article
Meta-Analysis
Research Support, Non-U.S. Gov't
Systematic Review

Language

eng

PubMed ID

33303564

Citation

Mantovani, Alessandro, et al. "Non-alcoholic Fatty Liver Disease and Risk of Incident Chronic Kidney Disease: an Updated Meta-analysis." Gut, vol. 71, no. 1, 2022, pp. 156-162.
Mantovani A, Petracca G, Beatrice G, et al. Non-alcoholic fatty liver disease and risk of incident chronic kidney disease: an updated meta-analysis. Gut. 2022;71(1):156-162.
Mantovani, A., Petracca, G., Beatrice, G., Csermely, A., Lonardo, A., Schattenberg, J. M., Tilg, H., Byrne, C. D., & Targher, G. (2022). Non-alcoholic fatty liver disease and risk of incident chronic kidney disease: an updated meta-analysis. Gut, 71(1), 156-162. https://doi.org/10.1136/gutjnl-2020-323082
Mantovani A, et al. Non-alcoholic Fatty Liver Disease and Risk of Incident Chronic Kidney Disease: an Updated Meta-analysis. Gut. 2022;71(1):156-162. PubMed PMID: 33303564.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Non-alcoholic fatty liver disease and risk of incident chronic kidney disease: an updated meta-analysis. AU - Mantovani,Alessandro, AU - Petracca,Graziana, AU - Beatrice,Giorgia, AU - Csermely,Alessandro, AU - Lonardo,Amedeo, AU - Schattenberg,Jörn M, AU - Tilg,Herbert, AU - Byrne,Christopher D, AU - Targher,Giovanni, Y1 - 2020/12/10/ PY - 2020/09/14/received PY - 2020/11/17/revised PY - 2020/12/01/accepted PY - 2020/12/12/pubmed PY - 2022/1/11/medline PY - 2020/12/11/entrez KW - fatty liver KW - meta-analysis KW - nonalcoholic steatohepatitis SP - 156 EP - 162 JF - Gut JO - Gut VL - 71 IS - 1 N2 - OBJECTIVE: Studies reported a significant association between non-alcoholic fatty liver disease (NAFLD) and increased risk of chronic kidney disease (CKD). However, whether this risk changes with increasing severity of NAFLD remains uncertain. We performed a meta-analysis of observational studies to quantify the magnitude of the association between NAFLD and risk of incident CKD. DESIGN: We systematically searched PubMed, Web of Science and Scopus from January 2000 to August 2020 using predefined keywords to identify observational studies with a follow-up duration of ≥1 year, in which NAFLD was diagnosed by blood biomarkers/scores, International Classification of Diseases codes, imaging techniques or biopsy. Data from selected studies were extracted, and meta-analysis was performed using random-effects modelling. RESULTS: 13 studies with 1 222 032 individuals (28.1% with NAFLD) and 33 840 cases of incident CKD stage ≥3 (defined as estimated glomerular filtration rate <60 mL/min/1.73 m2, with or without accompanying overt proteinuria) over a median follow-up of 9.7 years were included. NAFLD was associated with a moderately increased risk of incident CKD (n=10 studies; random-effects HR 1.43, 95% CI 1.33 to 1.54; I2 =60.7%). All risks were independent of age, sex, obesity, hypertension, diabetes and other conventional CKD risk factors. Sensitivity analyses did not alter these findings. Funnel plot did not reveal any significant publication bias. CONCLUSION: This large and updated meta-analysis indicates that NAFLD is significantly associated with a~1.45-fold increased long-term risk of incident CKD stage ≥3. Further studies are needed to examine the association between the severity of NAFLD and risk of incident CKD. SN - 1468-3288 UR - https://www.unboundmedicine.com/medline/citation/33303564/Non_alcoholic_fatty_liver_disease_and_risk_of_incident_chronic_kidney_disease:_an_updated_meta_analysis_ DB - PRIME DP - Unbound Medicine ER -