IDDF2022-ABS-0166 Urinary neutrophil gelatinase-associated lipocalin (NGAL); a novel biomarker for predicting chronic kidney disease (CKD) in patients with non-alcoholic fatty liver disease (NAFLD)

Abstract

<h3>Background</h3> There were reports of the significantly high prevalence of chronic kidney disease (CKD) in Non-alcoholic fatty liver disease (NAFLD) patients. Urinary neutrophil gelatinase-associated lipocalin (NGAL) is a reliable biomarker of renal dysfunction and is recommended for early detection of AKI in cirrhotic patients. There was no evidence of using urine NGAL for predicting CKD in NAFLD patients. We aim to determine the prevalence of CKD and identify the predictors of CKD in those patients. <h3>Methods</h3> A single-center, cross-sectional study was conducted between July 2018 and December 2019 in NAFLD patients diagnosed with Transient elastography (TE) or liver biopsy. Advanced liver fibrosis is defined as fibrosis stage 3–4. The definition of CKD is eGFR 2. Urine NGAL level was measured. <h3>Results</h3> A total of 101 NAFLD patients were included with a mean age of 54±16 years. Among 101 NAFLD patients, 59 (58.4%), 45 (44.6%), and 32 (31.7%) had significant fibrosis (&gt;F2), advanced fibrosis (&gt;F3), and cirrhosis (F4), respectively. The prevalence of CKD in NAFLD patients was 9% which the mean eGFR was 42.66±17.42 ml/min/1.73 m². The significant factors associated with CKD were a higher level of urine NGAL (137.79±222.66 vs 26.72±37.98; p=0.006); a higher level of TE (25.7±23.44 vs 10±8.71 kPa; p=0.038), and a presence of advanced fibrosis (77.8% vs 40.7%, p=0.041). Urine NGAL was the only significant factor associated with CKD in NAFLD patients. The cutoff level of urine NGAL of 36.75 ng/mL had OR 21.27 (95%CI 3.97–113.82; p&lt;0.001)) and 1.02 (95%CI 1.00–1.04; p=0.024) by univariate and multivariate analysis, respectively. This urine NGAL cutoff demonstrated sensitivity, and specificity of 77.8%, and 85.9% for predicting CKD, respectively. <h3>Conclusions</h3> The prevalence of CKD in NAFLD patients was 9% and the presence of advanced fibrosis is the significant risk factor associated with CKD. Urine NGAL was significantly associated with CKD in NAFLD patients with the cutoff level of 36.75 ng/mL for predicting CKD with acceptable sensitivity and specificity.