Byrne Christopher D, Targher Giovanni
Nutrition and Metabolism, Faculty of Medicine, University of Southampton, Southampton, UK; Southampton National Institute for Health Research Biomedical Research Centre, University Hospital Southampton, UK.
Division of Endocrinology, Diabetes and Metabolism, Department of Medicine, University and Azienda Ospedaliera Universitaria Integrata of Verona, Verona, Italy.
J Hepatol. 2020 Apr;72(4):785-801. doi: 10.1016/j.jhep.2020.01.013. Epub 2020 Feb 12.
Non-alcoholic fatty liver disease (NAFLD) and chronic kidney disease (CKD) are worldwide public health problems, affecting up to 25-30% (NAFLD), and up to 10-15% (CKD) of the general population. Recently, it has also been established that there is a strong association between NAFLD and CKD, regardless of the presence of potential confounding diseases such as obesity, hypertension and type 2 diabetes. Since NAFLD and CKD are both common diseases that often occur alongside other metabolic conditions, such as type 2 diabetes or metabolic syndrome, elucidating the relative impact of NAFLD on the risk of incident CKD presents a substantial challenge for investigators working in this research field. A growing body of epidemiological evidence suggests that NAFLD is an independent risk factor for CKD and recent evidence also suggests that associated factors such as metabolic syndrome, dysbiosis, unhealthy diets, platelet activation and processes associated with ageing could also contribute mechanisms linking NAFLD and CKD. This narrative review provides an overview of the literature on: a) the evidence for an association and causal link between NAFLD and CKD and b) the underlying mechanisms by which NAFLD (and factors strongly linked with NAFLD) may increase the risk of developing CKD.
非酒精性脂肪性肝病（NAFLD）和慢性肾脏病（CKD）是全球性的公共卫生问题，分别影响高达25%-30%（NAFLD）和10%-15%（CKD）的普通人群。最近还证实，无论是否存在肥胖、高血压和2型糖尿病等潜在混杂疾病，NAFLD与CKD之间都存在密切关联。由于NAFLD和CKD都是常见疾病，常与2型糖尿病或代谢综合征等其他代谢状况同时出现，因此阐明NAFLD对CKD发病风险的相对影响，对该研究领域的研究人员来说是一项重大挑战。越来越多的流行病学证据表明，NAFLD是CKD的独立危险因素，最近的证据还表明，代谢综合征、肠道菌群失调、不健康饮食、血小板活化以及与衰老相关的过程等相关因素，也可能是NAFLD与CKD之间联系的潜在机制。本叙述性综述概述了以下方面的文献：a）NAFLD与CKD之间存在关联和因果关系的证据；b）NAFLD（以及与NAFLD密切相关的因素）可能增加CKD发病风险的潜在机制。
