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Kidney Week

Abstract: TH-PO407

The Association Between FIB-4 Index and the Prevalence of CKD: The Fukuoka Kidney Disease Registry Study

Session Information

Category: CKD (Non-Dialysis)

  • 2101 CKD (Non-Dialysis): Epidemiology, Risk Factors, and Prevention


  • Hara, Masatoshi, Fukuoka Dental College, Tamura, Sawara-ku, Fukuoka, Japan
  • Tanaka, Shigeru, Kyushu University, Fukuoka, Japan
  • Torisu, Kumiko, Kyushu University, Fukuoka, Japan
  • Tokumoto, Masanori, Department of Internal Medicine, Fukuoka Dental College, Sawara-ku, FUKUOKA, Japan
  • Tsuruya, Kazuhiko, Nara Medical University, Kashihara, Japan
  • Ooboshi, Hiroaki, Fukuoka Dental College, Fukuoka, Japan
  • Nakano, Toshiaki, Kyushu University, Fukuoka, Japan
  • Kitazono, Takanari, Department of Medicine and Clinical Science, Fukuoka, Japan

Growing evidences have shown that non-alcoholic fatty liver disease (NAFLD) associates with chronic kidney disease (CKD). Liver biopsy is the gold standard for assessing the severity of NAFLD. However it is difficult to be used as a routine screening tool due to its possible risk. Therefore non-invasive assessments to evaluate NAFLD by combining clinical and routine laboratory parameters have been developed. One of such assessments, Fibrosis-4 (FIB-4) index, defined as as [age (years) × AST (U/L)/[platelet count (109/L) × √ALT (U/L)], has shown a good correlation with historical severity of NAFLD. However, it is still unclear whether FIB-4 index associates with CKD.


In this cross-sectional study, we included 3,197 CKD patients who participated in an ongoing prospective study, the Fukuoka Kidney disease Registry Study. We evaluated the association between FIB-4 index and either the prevalence of estimated glomerular filtration rate (eGFR)<60 ml/min/1.73 m2 or urinary albumin creatinine ratio (UACR)≥30 mg/g. Patients were divided into quartiles according to their baseline FIB-4 index levels: quartile (Q) 1, <1.12; Q2, 1.12–1.66; Q3, 1.67–2.30; and Q4, ≥2.31. The association between FIB-4 index levels and the prevalence of eGFR<60 ml/min/1.73 m2 or UACR≥30 mg/g was estimated using the logistic regression analysis.


In this study, 2464 (77.0%) patients were eGFR<60 ml/min/1.73 m2, and 2433 (76.1%) showed UACR≥30 mg/g. FIB-4 index was negatively correlated with eGFR levels (r = -0.38, P<0.001), whereas there was no correlations with UACR levels (r = 0.014, P = 0.42). The multivariable-adjusted odds ratios (ORs) and 95% confidence intervals (CIs) for prevalence of eGFR<60 ml/min/1.73 m2 were 1.25 (0.92–1.71), 1.50 (1.04–2.16), and 1.85 (1.18–2.89) in Q2, Q3, and Q4, respectively, compared with patients in the lowest category (Q1) (P for trend = 0.005). Every 0.1 increment in FIB-4 index was associated with a 1.03-fold (95% CI 1.01–1.05) increased prevalence of eGFR<60 ml/min/1.73 m2 after adjusting for the potential confounding factors.


Higher FIB-4 index was associated with higher ORs of eGFR<60 ml/min/1.73 m2. Further follow-up study is needed to determine whether FIB-4 index predicts the development and progression of CKD.