Abstract: FR-PO395

Non-Alcoholic Fatty Liver Disease Does Not Accelerate Progressive Renal Progression in Non-Dialysis CKD

Session Information

Category: Chronic Kidney Disease (Non-Dialysis)

  • 301 CKD: Risk Factors for Incidence and Progression

Authors

  • Chinnadurai, Rajkumar, SALFORD ROYAL NHS FOUNDATION TRUST, Manchester, United Kingdom
  • Vassallo, Diana, SALFORD ROYAL NHS FOUNDATION TRUST, Manchester, United Kingdom
  • Kalra, Philip A., SALFORD ROYAL NHS FOUNDATION TRUST, Manchester, United Kingdom
Background

Non-Alcoholic Fatty liver disease(NAFLD) is strongly associated with increased incidence and high prevalence of Chronic Kidney Disease(CKD). The association of NAFLD with renal disease progression in non-dialysis dependent CKD(NDD-CKD) has not been explored.Our aim is to access the impact of NAFLD on the rate of progression of CKD.

Methods

All patients recruited in the Salford Kidney Study(SKS)(Large prospective CKD database) who had an Ultrasound(US) of the liver performed between January 2000 to December 2014 were sampled in this retrospective observational study. Estimated Glomerular Filtration Rate(eGFR) as measured by CKD-EPI formula was collected for all patients from study start date (date of Ultrasound) until the study end which included commencement of renal replacement therapy or reaching eGFR <10 ml/min, death, loss to follow-up or censoring at 31 December 2015. The rate of decline in eGFR was calculated by the slope of linear regression in the total sample and a matched group obtained after propensity score matching of all baseline characteristics. All analysis was undertaken in SPSS.

Results

Of the 3061 patients registered in the SKS, 1419 patients had US imaging of the liver, either bespoke or as part of a general abdominal scan, during the study period. After excluding patients based on pre-set criteria, a sample of 852 (183 NAFLD and 669 normal US) patients with complete datasets remained. By Propensity Score matching 138 patients with and without NAFLD were matched. At baseline, the median age of the study group was 66 years, and median eGFR was 33.5 mL/min/1.73m2. Patients with NAFLD had more hypertension, diabetes mellitus and hypercholesterolemia. Body Mass Index was significantly higher in the NAFLD group 31 vs 27 kg/m2(p= <0.0001). Median Follow-up time was 73 months with no difference between groups(p=0.176). In terms of CKD progression, there was no difference in the rate of decline of eGFR between the two groups in the total sample (NAFLD: -2.54 ml/min/yr; normal liver: -2.09 ml/min/yr; p=0.088). Similar results were observed in the propensity score matched sample (NAFLD: -2.62 ml/min/yr; normal liver: -3.07 ml/min/yr; p-0.583).

Conclusion

In our Cohort of NDD-CKD patients the presence of NAFLD did not accelerate the rate of CKD progression.