Increased mortality in non-alcoholic fatty liver disease with chronic kidney disease is explained by metabolic comorbidities
(2019) In Clinics and Research in Hepatology and Gastroenterology 43(5). p.542-550- Abstract
Background: There is a close association between non-alcoholic fatty liver disease (NAFLD) and prevalent chronic kidney disease (CKD). Few longitudinal studies exist. No previous study has investigated to what extent CKD affects mortality in biopsy-proven NAFLD. Our aim was to investigate the long-term risk of developing CKD in biopsy-proven NAFLD and its effect on mortality. Methods: Patients with biopsy-proven NAFLD diagnosed in 1978-2006 in Malmö, Sweden were included. Estimated glomerular filtration rate (eGFR) at baseline and last follow-up was calculated with the CKD-EPI equation. CKD 3–5 (< 60 mL/min/1.73 m
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Background: There is a close association between non-alcoholic fatty liver disease (NAFLD) and prevalent chronic kidney disease (CKD). Few longitudinal studies exist. No previous study has investigated to what extent CKD affects mortality in biopsy-proven NAFLD. Our aim was to investigate the long-term risk of developing CKD in biopsy-proven NAFLD and its effect on mortality. Methods: Patients with biopsy-proven NAFLD diagnosed in 1978-2006 in Malmö, Sweden were included. Estimated glomerular filtration rate (eGFR) at baseline and last follow-up was calculated with the CKD-EPI equation. CKD 3–5 (< 60 mL/min/1.73 m
2
) was classified as CKD. Hospital medical records were extensively scrutinized from inclusion to endpoint (death or end of 2016). The prevalence of CKD was compared to a control group from the population-based prospective cohort Malmö Preventive Project (MPP). Results: 120 patients with biopsy-proven NAFLD were included. Mean age was 52.5 years and mean follow-up time 19.5 years. At baseline CKD prevalence in NAFLD was only significantly higher in the highest age group compared to controls (> 55 years, 25% vs. 9.5%, P = 0.003), and no significant difference was seen at follow-up (in total 37.5% vs. 30.8%, P = 0.124). NAFLD patients with long-term CKD had significantly higher crude overall mortality rate than NAFLD patients without CKD (P < 0.001). Regression analyses revealed that this increased mortality risk was explained by an increased prevalence of metabolic comorbidities (including diabetes mellitus), not CKD. Conclusion: Mortality risk is significantly increased in NAFLD patients with long-term CKD due to metabolic comorbidities, not influenced by CKD per se.
- author
- Önnerhag, Kristina LU ; Dreja, Karl LU ; Nilsson, Peter M. LU and Lindgren, Stefan LU
- organization
- publishing date
- 2019-03-01
- type
- Contribution to journal
- publication status
- published
- subject
- keywords
- Chronic kidney disease, Epidemiology, liver cirrhosis, Liver fibrosis, Metabolic syndrome, Mortality, non-alcoholic fatty liver disease
- in
- Clinics and Research in Hepatology and Gastroenterology
- volume
- 43
- issue
- 5
- pages
- 542 - 550
- publisher
- Elsevier Masson SAS
- external identifiers
-
- pmid:30827925
- scopus:85062090276
- ISSN
- 2210-7401
- DOI
- 10.1016/j.clinre.2019.02.004
- language
- English
- LU publication?
- yes
- id
- 682a4c8b-cf23-4c30-92a5-eb8bf034e6fb
- date added to LUP
- 2019-03-06 14:13:44
- date last changed
- 2024-04-16 01:19:52
@article{682a4c8b-cf23-4c30-92a5-eb8bf034e6fb,
abstract = {{<p><br>
Background: There is a close association between non-alcoholic fatty liver disease (NAFLD) and prevalent chronic kidney disease (CKD). Few longitudinal studies exist. No previous study has investigated to what extent CKD affects mortality in biopsy-proven NAFLD. Our aim was to investigate the long-term risk of developing CKD in biopsy-proven NAFLD and its effect on mortality. Methods: Patients with biopsy-proven NAFLD diagnosed in 1978-2006 in Malmö, Sweden were included. Estimated glomerular filtration rate (eGFR) at baseline and last follow-up was calculated with the CKD-EPI equation. CKD 3–5 (< 60 mL/min/1.73 m <br>
<sup>2</sup><br>
) was classified as CKD. Hospital medical records were extensively scrutinized from inclusion to endpoint (death or end of 2016). The prevalence of CKD was compared to a control group from the population-based prospective cohort Malmö Preventive Project (MPP). Results: 120 patients with biopsy-proven NAFLD were included. Mean age was 52.5 years and mean follow-up time 19.5 years. At baseline CKD prevalence in NAFLD was only significantly higher in the highest age group compared to controls (> 55 years, 25% vs. 9.5%, P = 0.003), and no significant difference was seen at follow-up (in total 37.5% vs. 30.8%, P = 0.124). NAFLD patients with long-term CKD had significantly higher crude overall mortality rate than NAFLD patients without CKD (P < 0.001). Regression analyses revealed that this increased mortality risk was explained by an increased prevalence of metabolic comorbidities (including diabetes mellitus), not CKD. Conclusion: Mortality risk is significantly increased in NAFLD patients with long-term CKD due to metabolic comorbidities, not influenced by CKD per se. <br>
</p>}},
author = {{Önnerhag, Kristina and Dreja, Karl and Nilsson, Peter M. and Lindgren, Stefan}},
issn = {{2210-7401}},
keywords = {{Chronic kidney disease; Epidemiology, liver cirrhosis; Liver fibrosis; Metabolic syndrome; Mortality; non-alcoholic fatty liver disease}},
language = {{eng}},
month = {{03}},
number = {{5}},
pages = {{542--550}},
publisher = {{Elsevier Masson SAS}},
series = {{Clinics and Research in Hepatology and Gastroenterology}},
title = {{Increased mortality in non-alcoholic fatty liver disease with chronic kidney disease is explained by metabolic comorbidities}},
url = {{http://dx.doi.org/10.1016/j.clinre.2019.02.004}},
doi = {{10.1016/j.clinre.2019.02.004}},
volume = {{43}},
year = {{2019}},
}