Abstract
Background and objectivesChronic kidney disease (CKD) share a common pathophysiology with non-alcoholic fatty liver disease (NAFLD). This study aims to identify the lipid derangements in patients of CKD and to associate them with radiological evidence of NAFLD.Material and methodsA cross-sectional observational study was performed in a tertiary care hospital, to include all chronic kidney disease patients (n=238) through non-probability consecutive sampling. The criteria for inclusion were baseline estimated Glomerular filtration rate (eGFR) below 60 ml/min/1.73m2 for at least three months and chronic renal parenchymal changes on ultrasound. Two study groups were identified based on ongoing hemodialysis, while two further study groups were identified based on radiological evidence of fatty liver disease.ResultsThe mean age of the study population was 48.52 ± 9.44 years with no difference amongst hemodialysis status, females elder than males (p= 0.027), those with fatty liver were much younger (p=0.014), and the most common age group below 50 years (p=0.005) among the fatty liver group. Radiological evidence of NAFLD was found amongst two-third of the study group with the status of hemodialysis indifferent among the study population (p=0.436). The mean values amongst fatty liver versus non-fatty liver groups revealed high creatinine, alanine transaminase (ALT), high-density lipoprotein (HDL), triglycerides (TG), and very-low-density lipoprotein (VLDL) in the fatty liver group, low-density lipoprotein (LDL) and total cholesterol (TC) were indifferent amongst the groups, while LDL/HDL ratio was higher in the non-fatty liver group.ConclusionA significantly higher HDL was found in fatty liver associated with CKD as compared to the non-fatty liver group.
Highlights
Chronic kidney disease (CKD) affects 8% of the total world population, with its prevalence increase with increasing age
Radiological evidence of non-alcoholic fatty liver disease (NAFLD) was found amongst two-third of the study group with the status of hemodialysis indifferent among the study population (p=0.436)
The mean values amongst fatty liver versus non-fatty liver groups revealed high creatinine, alanine transaminase (ALT), high-density lipoprotein (HDL), triglycerides (TG), and verylow-density lipoprotein (VLDL) in the fatty liver group, low-density lipoprotein (LDL) and total cholesterol (TC) were indifferent amongst the groups, while Low-density lipoprotein (LDL)/High-density lipoprotein (HDL) ratio was higher in the non-fatty liver group
Summary
Chronic kidney disease (CKD) affects 8% of the total world population, with its prevalence increase with increasing age. CKD and Non-alcoholic fatty liver disease (NAFLD) share a common pathophysiology. Like NAFLD, CKD is characterized by a deranged cellular substrate metabolism, fat deposition, which triggers oxidative stress and inflammatory and pro-fibrotic responses to drive the progression of both disease processes [1]. Hepatic steatosis with CKD results in a decrease in eGFR (estimated GFR) which may increase the severity of CKD [2]. CKD cause dyslipidemia, and hyperlipidemia has proven to increase the disease progress, the most common lipid abnormalities which have been noted are a decrease in High-density lipoprotein (HDL) and hypertriglyceridemia [3]. Chronic kidney disease (CKD) share a common pathophysiology with non-alcoholic fatty liver disease (NAFLD).
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