Study of Non-alcoholic fatty liver disease among chronic kidney disease patients by Controlled attenuation parameter

Abstract

Abstract Background/Aim Preliminary data suggest an association between chronic kidney disease (CKD) and non-alcoholic fatty liver disease (NAFLD). The aim of this study was evaluate the frequency of NAFLD and its associated risk factors among nondiabetic CKD patients not on dialysis. METHODS A total of 40 subjects were enrolled in the study. Group A (30) Pre dialysis non-diabetic CKD patiens and Group B (10) normal subjects matched for age and sex as a control group. Liver stiffness measurement was used to detect liver fibrosis and CAP (controlled attenuation parameter) was used to detect and quantify liver steatosis (Fibroscan®). NAFLD was defined by CAP values ≥238 dB/m. RESULTS Results of the current study showed that CKD stage III was present in 17 patients (56.7%) and CKD stage IV in 9 patients (30%) and CKD stage V in in 4 patients (13.3%). The total frequency of presence of steatosis (CAP values ≥238 dB/m) whatever degree was significantly higher in CKD group than control; More than (53%) of CKD patients have NAFLD, and (30%) of control group have NAFLD. The severity of liver steatosis was negatively correlated with GFR, Hb and HDL, and positively correlated with Creatinine, BUN, CRP, Cholesterol, TG, LDL, SGPT, SGOT, FBG and HBA1C. There was significant relation between steatosis and CKD etiology. (82.3%) of Patients with hypertension have Steatosis, (33.3%) of Patients with reflux nephropathy have steatosis, (16.7%) of Patients had other causes have steatosis, while patients had renal stones have no steatosis. There was significant positive correlation between fibrosis degree and age of CKD patients and also significant positive correlation between steatosis and fibrosis among CKD patients. The study showed significant positive correlation between SGPT and fibrosis degree. The results suggest a high prevalence of NAFLD in non-diabetic CKD patients. The severity of liver steatosis is negatively correlated with kidney function; there was significant correlation between CKD stage and other risk factors of hepatic steatosis