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Nonalcoholic fatty liver disease and risk of incident chronic kidney disease: an updated meta-analysis

Nonalcoholic fatty liver disease and risk of incident chronic kidney disease: an updated meta-analysis
Nonalcoholic fatty liver disease and risk of incident chronic kidney disease: an updated meta-analysis
Objective: studies reported a significant association between nonalcoholic 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 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 liver 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 hazard ratio [HR] 1.43, 95%CI 1.33‐1.54; 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 long‐term risk of incident CKD.
1468-3288
156-162
Mantovani, Alessandro
1ea688db-a469-4c78-87c6-c04c501073e5
Petracca, Graziana
bac32404-3b51-499a-bdaa-bf08d068e71c
Beatrice, Giorgia
df36a362-5613-4e8a-aacc-0b9345bc051a
Csermely, Alessandro
9f70c4a5-2591-4755-a429-270eadc27b05
Lonardo, Amedeo
7cbfc527-751f-47d5-bc29-86673f8c140f
Schattenberg, Jörn M.
7433e279-e5c5-4ebe-8a5e-ebbe09fbcce5
Tilg, Herbert
0eb10994-99f8-42a7-bae7-8216ff9ba363
Byrne, Christopher
1370b997-cead-4229-83a7-53301ed2a43c
Targher, Giovanni
043e0811-b389-4922-974e-22e650212c5f
Mantovani, Alessandro
1ea688db-a469-4c78-87c6-c04c501073e5
Petracca, Graziana
bac32404-3b51-499a-bdaa-bf08d068e71c
Beatrice, Giorgia
df36a362-5613-4e8a-aacc-0b9345bc051a
Csermely, Alessandro
9f70c4a5-2591-4755-a429-270eadc27b05
Lonardo, Amedeo
7cbfc527-751f-47d5-bc29-86673f8c140f
Schattenberg, Jörn M.
7433e279-e5c5-4ebe-8a5e-ebbe09fbcce5
Tilg, Herbert
0eb10994-99f8-42a7-bae7-8216ff9ba363
Byrne, Christopher
1370b997-cead-4229-83a7-53301ed2a43c
Targher, Giovanni
043e0811-b389-4922-974e-22e650212c5f

Mantovani, Alessandro, Petracca, Graziana, Beatrice, Giorgia, Csermely, Alessandro, Lonardo, Amedeo, Schattenberg, Jörn M., Tilg, Herbert, Byrne, Christopher and Targher, Giovanni (2020) Nonalcoholic fatty liver disease and risk of incident chronic kidney disease: an updated meta-analysis. Gut, 71 (1), 156-162. (doi:10.1136/gutjnl-2020-323082).

Record type: Review

Abstract

Objective: studies reported a significant association between nonalcoholic 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 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 liver 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 hazard ratio [HR] 1.43, 95%CI 1.33‐1.54; 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 long‐term risk of incident CKD.

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Accepted/In Press date: 1 December 2020
e-pub ahead of print date: 10 December 2020

Identifiers

Local EPrints ID: 445427
URI: http://eprints.soton.ac.uk/id/eprint/445427
ISSN: 1468-3288
PURE UUID: 336edf6e-eae6-46bb-89ee-f16e949155d2
ORCID for Christopher Byrne: ORCID iD orcid.org/0000-0001-6322-7753

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Date deposited: 08 Dec 2020 17:31
Last modified: 28 Apr 2022 04:37

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Contributors

Author: Alessandro Mantovani
Author: Graziana Petracca
Author: Giorgia Beatrice
Author: Alessandro Csermely
Author: Amedeo Lonardo
Author: Jörn M. Schattenberg
Author: Herbert Tilg
Author: Giovanni Targher

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