Abstract
Nonalcoholic fatty liver disease (NAFLD) is associated with several extrahepatic manifestations such as cardiovascular disease and sleep apnea. Furthermore, NAFLD is reported to be associated with an increased risk of incident chronic kidney disease (CKD). Inflammation and oxidative stress are suggested to be the key factors involved in the inflammatory mechanisms and pathways linking NAFLD to CKD and are responsible for both the pathogenesis and the progression of CKD in NAFLD patients. This review aims to provide a more comprehensive overview of the association between CKD and NAFLD, also considering the effect of increasing severity of NAFLD. A PubMed search was conducted using the terms “non-alcoholic fatty liver disease AND kidney”. In total, 537 articles were retrieved in the last five years and 12 articles were included in the qualitative analysis. Our results showed that CKD developed more frequently in NAFLD patients compared to those without NAFLD. This association persisted after adjustment for traditional risk factors and according to the severity of NAFLD. Therefore, patients with NAFLD should be considered at high risk of CKD. Intensive multidisciplinary surveillance over time is needed, where hepatologists and nephrologists must act together for better and earlier treatment of NAFLD patients.
Highlights
The liver and kidneys are recognized to be closely and mutually intertwined, both in physiological and pathological conditions [1]
Inflammation and oxidative stress are suggested to be the key factors involved in the inflammatory mechanisms and pathways linking nonalcoholic fatty liver disease (NAFLD) to chronic kidney disease (CKD) and responsible for both the pathogenesis and the progression of CKD in patients with NAFLD
NAFLD is associated with independently of traditional risk factors (HR 1.46, 95% CI 1.19–1.79)
Summary
The liver and kidneys are recognized to be closely and mutually intertwined, both in physiological and pathological conditions [1]. Renal dysfunction in the context of liver disease is multifactorial. Kidney disease [2] or can occur as a consequence of hepatitis B and C virus infections [3,4] or excessive alcohol consumption [5]. Was demonstrated to be significantly associated with increased risk of incident chronic kidney disease (CKD) [6]. NAFLD represents the most common chronic liver disease worldwide, affecting approximately 25% of global adult population. It should no longer be considered only a Western disease, and its prevalence is expected to further increase over the years [7,8]
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