Abstract

Nonalcoholic fatty liver disease has become the main concern of hepatologists around the world and the main research topic for identifying effective and safe therapy. Advances in the treatment of chronic viral hepatitis in recent years have opened the way towards reducing mortality in patients with chronic liver disease. This goal has not yet been reached, as the burden of chronic liver disease remains a future major health problem as the incidence of the nonalcoholic fatty liver disease continues to rise. The proportion of patients with liver cirrhosis and those with hepatocellular carcinoma due to nonalcoholic liver disease on the liver transplant waiting list has increased in the last years. The upward trend in the incidence and prevalence of the disease in recent decades raises concern over a possible global epidemic, especially as the disease is still underestimated and underdiagnosed. Chronic kidney disease presented an increase in incidence and prevalence during the last years, and it has been associated not only with increased morbidity and mortality but also with high costs for the health system. During the last decade, several studies have shown the association between nonalcoholic fatty disease and chronic kidney disease, two major worldwide health problems.

Highlights

  • Nonalcoholic fatty liver disease (NAFLD) and chronic kidney disease (CKD) are worldwide public health problems, due to their increasing prevalence, poor outcomes, and health care burden [1,2,3,4,5]

  • NAFLD covers a wide range of diseases from benign steatosis to nonalcoholic steatohepatitis (NASH) which is characterized by liver inflammation with high potential to progress to advanced fibrosis, liver cirrhosis, and hepatocellular carcinoma

  • Several studies have shown the association between NAFLD and CKD, regardless of the presence or not of known risk factors for diseases such as obesity, hypertension, type 2 diabetes mellitus (T2DM), or metabolic syndrome [7,8,9,10]

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Summary

Introduction

Nonalcoholic fatty liver disease (NAFLD) and chronic kidney disease (CKD) are worldwide public health problems, due to their increasing prevalence, poor outcomes, and health care burden [1,2,3,4,5]. NAFLD covers a wide range of diseases from benign steatosis (fat accumulation in >5% of hepatocytes, especially macrovesicular, without inflammation or fibrosis) to nonalcoholic steatohepatitis (NASH) which is characterized by liver inflammation with high potential to progress to advanced fibrosis, liver cirrhosis, and hepatocellular carcinoma. In a recent analysis of the ird National Health and Nutrition Survey database (including ∼11,700 American subjects), the moderate to advanced stages of CKD in patients with ultrasound-detected NAFLD were independently associated with increased all-cause mortality over a mean follow-up period of 19 years [6]. CKD has high rates in patients with NAFLD, ranging between 20% and 50% compared to 5% and 25% in those without [5, 11,12,13,14]

Chronic Kidney Disease
NAFLD and CKD
Findings
Full Text
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