Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea.
Department of Clinical Research Design and Evaluation, SAIHST, Sungkyunkwan University, Seoul, South Korea.
J Hepatol. 2017 Dec;67(6):1274-1280. doi: 10.1016/j.jhep.2017.08.024. Epub 2017 Sep 20.
BACKGROUND & AIMS: Non-alcoholic fatty liver disease (NAFLD) has been associated with chronic kidney disease (CKD), but cohort studies are limited. We investigated the longitudinal association of NAFLD and its severity with the development of CKD.
We performed a retrospective cohort study of 41,430 adult men and women (average age, 48.9y) without CKD at baseline who underwent repeated health check-up examinations from January 1, 2003, through December 31, 2013. NAFLD status was assessed by ultrasonography, and NAFLD severity was assessed by the NAFLD fibrosis score (NFS).
The outcome was an incident CKD, defined as an estimated glomerular filtration rate less than 60ml/min/1.73m. During 200,790 person-years of follow-up (median follow-up of 4.15years), we identified 691 incident CKD cases. The multivariable-adjusted hazard ratio for CKD comparing participants with and without NAFLD was 1.22 (95% confidence interval [CI] 1.04-1.43). The risk of CKD increased progressively with increased NAFLD severity. The multivariable-adjusted hazard ratios for CKD comparing participants with NFS <-1.455 and those with NFS ≥-1.455 to participants without NAFLD were 1.09 (95% CI 0.91-1.32) and 1.58 (95% CI 1.30-1.92), respectively. The association was consistent across clinically relevant subgroups.
In a large cohort of adult men and women without CKD, NAFLD was associated with an increased risk of CKD development. NAFLD may adversely affect renal function and patients may need to be carefully monitored for an increased risk of CKD.
The presence of fatty liver is associated with the future decline of renal function. Thus, fatty liver patients need to be monitored regularly for renal function.
非酒精性脂肪性肝病（NAFLD）与慢性肾脏病（CKD）相关，但队列研究有限。我们研究了 NAFLD 及其严重程度与 CKD 发展的纵向关联。
我们对 2003 年 1 月 1 日至 2013 年 12 月 31 日期间未患有 CKD 的 41430 名成年男女进行了回顾性队列研究（平均年龄为 48.9 岁），这些人接受了重复的健康检查。NAFLD 状态通过超声检查评估，NAFLD 严重程度通过 NAFLD 纤维化评分（NFS）评估。
结局是新发 CKD，定义为估计肾小球滤过率小于 60ml/min/1.73m。在 200790 人年的随访期间（中位随访时间为 4.15 年），我们发现了 691 例新发 CKD 病例。与无 NAFLD 者相比，NAFLD 患者发生 CKD 的多变量调整后的危险比为 1.22（95%置信区间 [CI] 1.04-1.43）。随着 NAFLD 严重程度的增加，CKD 的风险逐渐增加。与 NFS <-1.455 的参与者相比，与 NFS ≥-1.455 的参与者相比，NFS 为-1.455 的参与者发生 CKD 的多变量调整后的危险比分别为 1.09（95%CI 0.91-1.32）和 1.58（95%CI 1.30-1.92）。该关联在临床相关亚组中一致。
在没有 CKD 的大量成年男女队列中，NAFLD 与 CKD 发展风险增加相关。NAFLD 可能对肾功能产生不利影响，患者可能需要密切监测 CKD 风险增加的情况。
非专业人士翻译，仅供参考。
