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Higher liver stiffness scores are associated with early kidney dysfunction in patients with histologically-proven non-cirrhotic NAFLD

Higher liver stiffness scores are associated with early kidney dysfunction in patients with histologically-proven non-cirrhotic NAFLD
Higher liver stiffness scores are associated with early kidney dysfunction in patients with histologically-proven non-cirrhotic NAFLD

Aim: The association between liver fibrosis (LF), as assessed by either histology or liver stiffness measurement (LSM), and the presence of early kidney dysfunction (EKD) was investigated in this study, as was also the diagnostic performance of LSM for identifying the presence of EKD in patients with non-alcoholic fatty liver disease (NAFLD).

Materials and Methods: A total of 214 adults with non-cirrhotic biopsy-proven NAFLD were recruited from two independent medical centres. Their histological stage of LF was quantified using Brunt’s criteria. Vibration-controlled transient elastography (TE), using M-probe (FibroScan®) ultrasound, was performed in 154 patients and defined as significant when LSM was ≥ 8.0 kPa. EKD was defined as the presence of microalbuminuria with an estimated glomerular filtration rate ≥ 60 mL/min/1.73 m2. Logistic regression modelling was used to estimate the likelihood of having EKD with NAFLD (LSM–EKD model).

Results: The prevalence of EKD was higher in patients with vs without LF on histology (22.14% vs 4.82%, respectively; P < 0.001) and, similarly, EKD prevalence was higher in patients with LSM ≥ 8.0 kPa vs LSM < 8.0 kPa (23.81% vs 6.59%, respectively; P < 0.05). The area under the ROC curve of the LSM–EKD model for identifying EKD was 0.80 (95% CI: 0.72–0.89). LF detected by either method was associated with EKD independently of established renal risk factors and potential confounders.

Conclusion: LF was independently associated with EKD in patients with biopsy-proven NAFLD. Thus, TE-measured LSM, a widely used technique for quantifying LF, can accurately identify those patients with NAFLD who are at risk of having EKD.

Early kidney dysfunction, Liver fibrosis, Liver stiffness measurement, Non-alcoholic fatty liver disease
1262-3636
288-295
Sun, Dan-Qin
4742a7c1-bad5-4ccc-886a-3d07f0c3b4f5
Ye, Fang-Zhou
7615ae0b-6ab3-445b-a90c-cbe9c5c950f6
Kani, Haluk Tarik
a40b51fa-ace0-488b-a071-bc185c94798c
Yang, Jian-Rong
5228f305-49fd-4366-9c6b-0ed9a0b8aef7
Zheng, Kenneth I.
64ff6443-ee9b-4600-92b1-787c3b1e3594
Zhang, Hao-Yang
5fc69484-cc5e-4aec-aa4a-5b02d9845da6
Targher, Giovanni
043e0811-b389-4922-974e-22e650212c5f
Byrne, Christopher
1370b997-cead-4229-83a7-53301ed2a43c
Chen, Yong-Ping
de133374-eea5-4630-8802-ad05df9607e3
Yuan, Wei-Jie
f87bec69-ce50-4e7b-b2b8-a1961fe28281
Yilmaz, Yusuf
612acb5a-7365-438a-8228-51445bd65dc9
Zheng, Ming-Hua
61ae0401-fa16-4fdb-913b-5bb97823998e
Sun, Dan-Qin
4742a7c1-bad5-4ccc-886a-3d07f0c3b4f5
Ye, Fang-Zhou
7615ae0b-6ab3-445b-a90c-cbe9c5c950f6
Kani, Haluk Tarik
a40b51fa-ace0-488b-a071-bc185c94798c
Yang, Jian-Rong
5228f305-49fd-4366-9c6b-0ed9a0b8aef7
Zheng, Kenneth I.
64ff6443-ee9b-4600-92b1-787c3b1e3594
Zhang, Hao-Yang
5fc69484-cc5e-4aec-aa4a-5b02d9845da6
Targher, Giovanni
043e0811-b389-4922-974e-22e650212c5f
Byrne, Christopher
1370b997-cead-4229-83a7-53301ed2a43c
Chen, Yong-Ping
de133374-eea5-4630-8802-ad05df9607e3
Yuan, Wei-Jie
f87bec69-ce50-4e7b-b2b8-a1961fe28281
Yilmaz, Yusuf
612acb5a-7365-438a-8228-51445bd65dc9
Zheng, Ming-Hua
61ae0401-fa16-4fdb-913b-5bb97823998e

Sun, Dan-Qin, Ye, Fang-Zhou, Kani, Haluk Tarik, Yang, Jian-Rong, Zheng, Kenneth I., Zhang, Hao-Yang, Targher, Giovanni, Byrne, Christopher, Chen, Yong-Ping, Yuan, Wei-Jie, Yilmaz, Yusuf and Zheng, Ming-Hua (2020) Higher liver stiffness scores are associated with early kidney dysfunction in patients with histologically-proven non-cirrhotic NAFLD. Diabetes & Metabolism, 46 (4), 288-295. (doi:10.1016/j.diabet.2019.11.003).

Record type: Article

Abstract

Aim: The association between liver fibrosis (LF), as assessed by either histology or liver stiffness measurement (LSM), and the presence of early kidney dysfunction (EKD) was investigated in this study, as was also the diagnostic performance of LSM for identifying the presence of EKD in patients with non-alcoholic fatty liver disease (NAFLD).

Materials and Methods: A total of 214 adults with non-cirrhotic biopsy-proven NAFLD were recruited from two independent medical centres. Their histological stage of LF was quantified using Brunt’s criteria. Vibration-controlled transient elastography (TE), using M-probe (FibroScan®) ultrasound, was performed in 154 patients and defined as significant when LSM was ≥ 8.0 kPa. EKD was defined as the presence of microalbuminuria with an estimated glomerular filtration rate ≥ 60 mL/min/1.73 m2. Logistic regression modelling was used to estimate the likelihood of having EKD with NAFLD (LSM–EKD model).

Results: The prevalence of EKD was higher in patients with vs without LF on histology (22.14% vs 4.82%, respectively; P < 0.001) and, similarly, EKD prevalence was higher in patients with LSM ≥ 8.0 kPa vs LSM < 8.0 kPa (23.81% vs 6.59%, respectively; P < 0.05). The area under the ROC curve of the LSM–EKD model for identifying EKD was 0.80 (95% CI: 0.72–0.89). LF detected by either method was associated with EKD independently of established renal risk factors and potential confounders.

Conclusion: LF was independently associated with EKD in patients with biopsy-proven NAFLD. Thus, TE-measured LSM, a widely used technique for quantifying LF, can accurately identify those patients with NAFLD who are at risk of having EKD.

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Accepted/In Press date: 10 November 2019
e-pub ahead of print date: 28 November 2019
Published date: 1 September 2020
Keywords: Early kidney dysfunction, Liver fibrosis, Liver stiffness measurement, Non-alcoholic fatty liver disease

Identifiers

Local EPrints ID: 435780
URI: http://eprints.soton.ac.uk/id/eprint/435780
ISSN: 1262-3636
PURE UUID: 5eafd1af-a412-49f0-8685-ddc4d43e9ebc
ORCID for Christopher Byrne: ORCID iD orcid.org/0000-0001-6322-7753

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Date deposited: 20 Nov 2019 17:30
Last modified: 17 Mar 2024 05:02

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Contributors

Author: Dan-Qin Sun
Author: Fang-Zhou Ye
Author: Haluk Tarik Kani
Author: Jian-Rong Yang
Author: Kenneth I. Zheng
Author: Hao-Yang Zhang
Author: Giovanni Targher
Author: Yong-Ping Chen
Author: Wei-Jie Yuan
Author: Yusuf Yilmaz
Author: Ming-Hua Zheng

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