Department of Nephrology and Dialysis, Division of Internal medicine, University Hospital Center Rijeka, Rijeka, Croatia.
Kidney Blood Press Res. 2013;37(4-5):305-10. doi: 10.1159/000350158. Epub 2013 Sep 12.
BACKGROUND/AIM: Preliminary data suggest an association between chronic kidney disease (CKD) and non-alcoholic fatty liver disease (NAFLD). The aim of this study was to further investigate the association between NAFLD and decreased kidney function.
A total of 62 patients with CKD were enrolled in the study. Liver stiffness was used to detect liver fibrosis and CAP (controlled attenuation parameter) was used to detect and quantify liver steatosis (Fibroscan®). NAFLD was defined by CAP values ≥238 dB.m(-1).
CKD stage III was present in 29 patients (46.8%) and CKD stage IV in 33 patients (53.2%). Out of 62 CKD patients 53 (85.5%) had NAFLD and of these 14/53 patients (26.4%) had also liver stiffness >7 kPa. The severity of liver steatosis was positively correlated with serum creatinine (r=0.399;p<0.01) and CRP (r=0.261; p<0.05) and negatively correlated with eGFR (r=-0.413; p<0.01) and serum iron concentration (r=-0.365; p<0.01).
The results suggest a high prevalence of NAFLD in CKD patients. The severity of liver steatosis is negatively correlated with kidney function. The study documents the value of ultrasonographic elastography as an effective non-invasive screening method for the diagnosis of NAFLD.
背景/目的：初步数据表明慢性肾脏病（CKD）与非酒精性脂肪性肝病（NAFLD）之间存在关联。本研究的目的是进一步研究 NAFLD 与肾功能下降之间的关系。
共纳入 62 例 CKD 患者。采用肝硬度检测肝纤维化，CAP（受控衰减参数）检测和定量肝脂肪变性（Fibroscan®）。CAP 值≥238dB.m(-1)定义为 NAFLD。
29 例（46.8%）患者为 CKD Ⅲ期，33 例（53.2%）患者为 CKD Ⅳ期。62 例 CKD 患者中 53 例（85.5%）存在 NAFLD，其中 14/53 例（26.4%）患者肝硬度>7kPa。肝脂肪变性的严重程度与血清肌酐（r=0.399;p<0.01）和 CRP（r=0.261;p<0.05）呈正相关，与 eGFR（r=-0.413;p<0.01）和血清铁浓度（r=-0.365;p<0.01）呈负相关。
研究结果表明 CKD 患者中 NAFLD 的患病率较高。肝脂肪变性的严重程度与肾功能呈负相关。该研究证明了超声弹性成像作为一种有效的非侵入性筛查方法用于诊断 NAFLD 的价值。
