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Abstract: PO2246

Advanced Liver Fibrosis Predicts CKD Development in Patients with Nonalcoholic Fatty Liver Disease

Session Information

Category: CKD (Non-Dialysis)

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

Authors

  • Jung, Chan-Young, Yonsei University College of Medicine, Seoul, Seoul, Korea (the Republic of)
  • Kim, Hyung Woo, Yonsei University College of Medicine, Seoul, Seoul, Korea (the Republic of)
  • Kim, Beom seok, Yonsei University College of Medicine, Seoul, Seoul, Korea (the Republic of)
Background

Nonalcoholic fatty liver disease (NAFLD) and chronic kidney disease (CKD) are progressive chronic conditions that share important cardiometabolic risk factors and pathogenic mechanisms. We investigated the association between liver fibrosis and the risk of incident CKD in patients with NAFLD.

Methods

A total of 5,983 participants with NAFLD (defined as controlled attenuation parameter >222 dB/m) but without CKD who underwent transient elastography (TE) between March 2012 and August 2018 were selected. The primary outcome was incident CKD, defined as the occurrence of estimated glomerular filtration rate (eGFR) <60 mL/min/1.73 m2 or proteinuria (≥1+ on dipstick test) on two consecutive measurements during follow-up. The secondary outcome was a 25% decline in eGFR measured on two consecutive visits.

Results

The mean age was 51.8 years and 3,756 (62.8%) participants were male. During 17,801 person-years of follow-up (mean follow-up of 3.0 years), 62 participants (1.0%) developed incident CKD. When stratified into TE-defined fibrosis stages, multivariable Cox models revealed that risk of incident CKD was 3.63-fold (95% CI, 1.64-8.06, P<0.001) higher in the F3-4 group (≥9.5 kPa), compared to the F0 group (<5.5 kPa). During 17,577 person-years of follow-up (mean follow-up of 3.0 years), 201 participants (3.4%) experienced the secondary outcome, for which the F3-4 group had a 2.69-fold increased risk (95% CI, 1.70-4.27, P<0.001), compared to the F0 group.

Conclusion

In this large cohort of NAFLD patients without baseline CKD, advanced liver fibrosis measured by transient elastography was significantly associated with a higher risk of incident CKD.