Abstract: TH-PO485

Associations of Cardio-Renal Biomarkers in CKD Patients with Non-Alcoholic Fatty Liver Disease

Session Information

Category: Chronic Kidney Disease (Non-Dialysis)

  • 303 CKD: Epidemiology, Outcomes - Cardiovascular

Authors

  • Chinnadurai, Rajkumar, SALFORD ROYAL NHS FOUNDATION TRUST, Manchester, United Kingdom
  • Alderson, Helen, SALFORD ROYAL NHS FOUNDATION TRUST, Manchester, United Kingdom
  • Kalra, Philip A., Salford Royal Hospital NHS Trust, Salford, United Kingdom
Background

Non-Alcoholic Fatty Liver Disease (NAFLD) and Chronic Kidney Disease (CKD) are both associated with increased risk of cardiovascular disease(CVD). Novel biomarkers may aid early diagnosis and guide prognosis. We studied the associations of Cardio-Renal biomarkers in a cohort of non-dialysis dependent CKD (NDD-CKD) patients with NAFLD.

Methods

Patients with and without ultrasound characteristics of NAFLD were identified within the Salford Kidney Study(SKS), a large single-centre NDD-CKD cohort study. Associations of important biomarkers (KIM-1, NGAL, MPO, Anti ApoA1, NTproBNP and HsTNT) with NAFLD and major outcomes (MACE, mortality and ESKD) were studied using Cox-Regression analysis.

Results

Of the 3061 patients registered in SKS, 630 patients (NAFLD-137, Normal-493) had had liver US, complete datasets and analysis of baseline CRBM. Demographics and median values (with IQR) of biomarkers are expressed in the Table.In a Multivariable Cox-Regression Model adjusted for age, gender, NAFLD Status and baseline history of cardiovascular risk factors, TropT (HR:1.008, P=0.021), NGAL (HR:1.003, P<0.001) and KIM-1(HR-1.001, P=0.005) showed associations with MACE. All biomarkers except Anti Apo-A1 showed a positive association with mortality with Trop T showing a strong association HR 1.012, P<0.001. Higher KIM-1 and NGAL were associated with progression to ESKD.

Conclusion

The biomarker associations were very much reflective of the renal and cardiac status of the patient group. A strong independent association of biomarkers was observed with outcomes in this cohort, but NAFLD was not independently associated with any particular pattern.

VARIABLENAFLD(n=137)NORMAL(n=493)pValue (NAFLD vs Normal)
Age (Years:range)65(59-72)67(54-74)0.237
Gender(Male)84(61.3%)294(59.6%)0.723
Anti-Apo-A1(OD)0.51(0.31-0.74)0.48(0.30-0.77)0.814
KIM-1(pg/ml)364.4(254.7-561.7)338.6(220.5-527.9)0.137
MPO(ng/ml)28.7(21.5-52.9)36.5(20.9-59.7)0.055
NGAL(ng/ml)191.9(142.8-262.1)214.6(136-323.8)0.054
NTproBNP(pg/ml)179.7(78-544)299.7(116.6-958.9)0.005
HsTrop(ng/ml)14.9(7.8-23.7)15.7(7.9-28.7)0.541
Creatinine(umol/L)143(110-191)174(131-236)0.000
eGFR(CKD-EPI) ml/min/1.73sqm39.6(28.6-58.2)31.2(20.4-44.1)0.000