Abstract
Hepatic steatosis and chronic kidney disease (CKD) in the advanced stages are closely related to cardiovascular diseases. Despite the potential connection between early CKD (G1-G3a) and hepatic steatosis on cardiometabolic risks, few studies have revealed their causal link to ischemic heart disease (IHD). We prospectively investigated the combined effect of CKD in earlier stages and hepatic steatosis on incident IHD risk in large-scale, non-diabetic Koreans. Data were assessed from 16,531 participants without diabetes from the Health Risk Assessment Study (HERAS) and Korea Health Insurance Review and Assessment (HIRA) data. We divided the study population into four groups according to the existence of early CKD and hepatic steatosis: controls, early CKD only, hepatic steatosis only, and both early CKD and hepatic steatosis. We prospectively assessed hazard ratios (HRs) with 95% confidence intervals (CIs) for IHD using multivariate Cox proportional-hazard regression models over a 50-month period. During the follow-up period, 326 (2.0%) patients developed IHD. HRs of IHD in the four groups were 1.00 (controls), 1.26 (95% CI 0.72–2.19), 1.19 (95% CI 0.90–1.57) and 1.76 (95% CI 1.04–2.97), respectively, after adjusting for potential confounding variables. Even less than stage 3A, CKD could precede and predict IHD in patients with hepatic steatosis.
Highlights
Both chronic kidney disease (CKD) and hepatic steatosis have been increasing over the decades; simultaneously, the healthcare burden is gradually increasing for managing each of these diseases
The presence of early CKD with hepatic steatosis was associated with a 76.0% increase in the risk of developing ischemic heart disease (IHD) compared with those without CKD and hepatic steatosis (HR = 1.76; 95% confidence intervals (CIs), 1.04–2.97)
We found a combined effect of early CKD and liver steatosis on the incidence of IHD
Summary
Publisher’s Note: MDPI stays neutral with regard to jurisdictional claims in published maps and institutional affiliations. Both chronic kidney disease (CKD) and hepatic steatosis have been increasing over the decades; simultaneously, the healthcare burden is gradually increasing for managing each of these diseases. The mean global prevalence of CKD is 13.4% in all stages [1]. CKD can accelerate hypertension, diabetes, and metabolic syndrome, which are significant risk factors for cardiovascular diseases (CVDs) [2,3]. Most studies have shown these associations in the advanced stages of CKD, including end-stage renal disease (ESRD) [4]
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