Cai Xiaoyan, Sun Lichang, Liu Xiong, Zhu Hailan, Zhang Yang, Zheng Sulin, Huang Yuli
Department of Scientific Research and Education, Shunde Hospital, Southern Medical University, Foshan, China.
Department of Cardiology, Shunde Hospital, Southern Medical University, Foshan, China.
Ther Adv Chronic Dis. 2021 Jun 23;12:20406223211024361. doi: 10.1177/20406223211024361. eCollection 2021.
Whether non-alcoholic fatty liver disease (NAFLD) is associated with an increased risk of incident chronic kidney disease (CKD) independent of established cardio-renal risk factors remains controversial. We aimed to provide a quantitative estimate of the association and strength between NAFLD and risk of CKD after adjustment for multiple cardio-renal risk factors.
We searched electronic databases (PubMed, Embase, and Google Scholar) for studies published from database inception until 30 November 2020. Analysis included cohort studies that reported multivariable-adjusted risk ratios [including odds ratios, relative risks (RRs), or hazard ratios] and 95% confidence intervals (CIs) for CKD of NAFLD compared with individuals without NAFLD.
A total of 11 cohort studies were included comprising 1,198,242 participants (46.3% women) for analysis. The median follow-up duration was 3.7 years, with 31,922 cases of incident CKD. Compared with individuals without NAFLD, unadjusted models showed that NAFLD was associated with a higher risk of CKD (RR 1.54, 95% CI 1.38-1.71). After adjusting for multiple cardio-renal risk factors, the CKD risk was still significantly increased in patients with NAFLD (RR 1.39, 95% CI 1.27-1.52). Compared with individuals without NAFLD, the adjusted absolute risk increase in NAFLD for CKD was 5.1 (95% CI 3.5-6.8) per 1000 person-years.
NAFLD is associated with an increased risk of incident CKD independent of established cardio-renal risk factors.
非酒精性脂肪性肝病（NAFLD）是否与新发慢性肾脏病（CKD）风险增加相关，且独立于已确定的心血管肾脏危险因素，仍存在争议。我们旨在对多种心血管肾脏危险因素进行调整后，定量评估NAFLD与CKD风险之间的关联及强度。
我们检索了电子数据库（PubMed、Embase和谷歌学术），查找从数据库建立至2020年11月30日发表的研究。分析纳入了队列研究，这些研究报告了与无NAFLD个体相比，NAFLD发生CKD的多变量调整风险比[包括比值比、相对风险（RR）或风险比]及95%置信区间（CI）。
共纳入11项队列研究，包括1198242名参与者（46.3%为女性）进行分析。中位随访时间为3.7年，有31922例新发CKD病例。与无NAFLD个体相比，未调整模型显示NAFLD与更高的CKD风险相关（RR 1.54，95%CI 1.38 - 1.71）。在对多种心血管肾脏危险因素进行调整后，NAFLD患者的CKD风险仍显著增加（RR 1.39，95%CI 1.27 - 1.52）。与无NAFLD个体相比，NAFLD患者CKD的调整后绝对风险增加为每1000人年5.1（95%CI 3.5 - 6.8）。
NAFLD与新发CKD风险增加相关，且独立于已确定的心血管肾脏危险因素。
