Department of Gastroenterology, Hepatology and Infectious Diseases, University Hospital Duesseldorf, Medical Faculty of Heinrich Heine University Duesseldorf, Moorenstraße 5, 40225, Duesseldorf, Germany.
Department of Surgery (A), University Hospital Duesseldorf, Medical Faculty of Heinrich Heine University Duesseldorf, 40225, Duesseldorf, Germany.
Eur J Med Res. 2023 Apr 17;28(1):153. doi: 10.1186/s40001-023-01114-6.
Non-alcoholic fatty liver disease (NAFLD) is the leading cause of chronic liver disease in the western world. The excess mortality in NAFLD patients is strongly related to extrahepatic comorbidities. Recently, an association between NAFLD and chronic kidney disease (CKD) has been reported in various populations.
Based on the IQVIA Disease Analyzer database, this retrospective study examined two cohorts from Germany matched for sex, age, index year, annual visit frequency, hypertension, and diabetes, including 92,225 patients with and without NAFLD. The incidence of CKD was assessed as a function of NAFLD using Cox regression models.
A total of 92,225 NAFLD patients as well as 92,225 patients without NAFLD were included into analyses. CKD was diagnosed in 19.1% vs. 11.1% of patients with and without NAFLD within the 10 years observation period (p < 0.001). Cox regression confirmed a significant association between NAFLD and CKD with a hazard ratio (HR) of 1.80 (95%CI: 1.73-1.86, p < 0.001). Subgroup analyses revealed that this association was most pronounced in the age group of 18 to 50 years (HR: 2.13, 95%CI: 1.91-2.37, p < 0.001) and among female NAFLD patients (HR 1.85, 95%CI: 1.76-1.95, p < 0.001).
The results of this study confirm a significantly increased risk of developing CKD in a large, real-world cohort of adult NAFLD patients in Germany. Interdisciplinary care of NAFLD patients, which is currently gaining importance worldwide, should be considered to include systematic measures for prevention and/or early detection of CKD with the aim of minimizing long-term renal complications.
非酒精性脂肪性肝病（NAFLD）是西方世界慢性肝病的主要原因。NAFLD 患者的超额死亡率与肝外合并症密切相关。最近，在各种人群中已经报道了 NAFLD 与慢性肾脏病（CKD）之间的关联。
基于 IQVIA 疾病分析器数据库，这项回顾性研究检查了来自德国的两个队列，这些队列在性别、年龄、索引年、年度就诊频率、高血压和糖尿病方面相匹配，包括 92225 例有和无 NAFLD 的患者。使用 Cox 回归模型评估了 CKD 的发生率与 NAFLD 的关系。
共有 92225 例 NAFLD 患者和 92225 例无 NAFLD 的患者被纳入分析。在 10 年的观察期内，有 CKD 的患者分别占患者的 19.1%和 11.1%（p<0.001）。Cox 回归证实了 NAFLD 与 CKD 之间的显著关联，风险比（HR）为 1.80（95%CI：1.73-1.86，p<0.001）。亚组分析显示，这种关联在 18 至 50 岁年龄组中最为明显（HR：2.13，95%CI：1.91-2.37，p<0.001），且在女性 NAFLD 患者中更为明显（HR 1.85，95%CI：1.76-1.95，p<0.001）。
这项研究的结果证实，在德国一个大型的、真实世界的成年 NAFLD 患者队列中，CKD 的发生风险显著增加。目前，全球范围内正在重视对 NAFLD 患者的跨学科治疗，应该考虑将系统的预防和/或早期发现 CKD 的措施纳入其中，以最大限度地减少长期肾脏并发症。
