Abstract
The association between nonalcoholic fatty liver disease (NAFLD) and chronic kidney disease has attracted interest and attention over recent years. However, no data are available in children. We determined whether children with NAFLD show signs of renal functional alterations, as determined by estimated glomerular filtration rate (eGFR) and urinary albumin excretion. We studied 596 children with overweight/obesity, 268 with NAFLD (hepatic fat fraction ≥5% on magnetic resonance imaging) and 328 without NAFLD, and 130 healthy normal-weight controls. Decreased GFR was defined as eGFR < 90 mL/min/1.73 m2. Abnormal albuminuria was defined as urinary excretion of ≥30 mg/24 h of albumin. A greater prevalence of eGFR < 90 mL/min/1.73 m2 was observed in patients with NAFLD compared to those without liver involvement and healthy subjects (17.5% vs. 6.7% vs. 0.77%; p < 0.0001). The proportion of children with abnormal albuminuria was also higher in the NAFLD group compared to those without NAFLD, and controls (9.3% vs. 4.0% vs. 0; p < 0.0001). Multivariate logistic regression analysis revealed that NAFLD was associated with decreased eGFR and/or microalbuminuria (odds ratio, 2.54 (confidence interval, 1.16–5.57); p < 0.05) independently of anthropometric and clinical variables. Children with NAFLD are at risk for early renal dysfunction. Recognition of this abnormality in the young may help to prevent the ongoing development of the disease.
Highlights
Concurrent with the epidemic of obesity across the world, nonalcoholic fatty liver disease (NAFLD) is becoming one of the most prevalent chronic liver disorders in both adults and children
It is known that NAFLD is a risk factor for hepatic failure and hepatic carcinoma, but it is associated with a spectrum of extrahepatic diseases generally linked to metabolic syndrome (MetS) such as type 2 diabetes, and cardiovascular disease [1,2]
Obese children with NAFLD and obese subjects without NAFLD had significantly higher estimated glomerular filtration rate (eGFR) compared to healthy controls (median, 115 and 115 (96–132) vs. 108 (100–118) mL/min/1.73 m2; p < 0.0001), whereas no differences were found between patients with and without NAFLD
Summary
Concurrent with the epidemic of obesity across the world, nonalcoholic fatty liver disease (NAFLD) is becoming one of the most prevalent chronic liver disorders in both adults and children. Recent studies in the pediatric obese population have demonstrated that the prevalence of prediabetes and MetS is significantly increased in subjects with increased hepatic fat content, and that liver steatosis, independently of visceral and intramyocellular lipid content, is a key determinant of the impairment of liver, muscle, and adipose insulin sensitivity [3,4]. No data are available in children regarding a possible association between NAFLD and impaired renal function. Recognition of the influence of NAFLD on renal function in the early age would enable us to better understand the association of NAFLD and CKD, since there is less potential for confusion with adult-onset complications
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
