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논문분류	춘계학술대회 초록집
제목	Advanced liver fibrosis predicts chronic kidney disease development in patients with nonalcoholic fatty liver disease
저자	Chan-Young Jung, Geun Woo Ryu, Hyung Woo Kim, Sang Hoon Ahn, Seung Up Kim, Beom Seok Kim
출판정보	2021; 2021(1):
키워드
초록	Objective: A total of 5,983 participants with NAFLD (defined as controlled attenuation parameter >222 dB/m) but without CKD who underwent transient elastography (TE) between March 2012 and August 2018 were selected. The primary outcome was incident CKD, defined as the occurrence of estimated glomerular filtration rate (eGFR) <60 mL/min/1.73 m2 or proteinuria (≥1+ on dipstick test) on two consecutive measurements during follow-up. The secondary outcome was a 25% decline in eGFR measured on two consecutive visits. Methods: The mean age was 51.8 years and 3,756 (62.8%) participants were male. During 17,801 person-years of follow-up (mean follow-up of 3.0 years), 62 participants (1.0%) developed incident CKD. When stratified into TE-defined fibrosis stages, multivariable Cox models revealed that risk of incident CKD was 3.63-fold (95% CI, 1.64-8.06, P<0.001) higher in the F3-4 group (≥9.5 kPa), compared to the F0 group (<5.5 kPa). During 17,577 person-years of follow-up (mean follow-up of 3.0 years), 201 participants (3.4%) experienced the secondary outcome, for which the F3-4 group had a 2.69-fold increased risk (95% CI, 1.70-4.27, P<0.001), compared to the F0 group. Results: In this large cohort of NAFLD patients without baseline CKD, advanced liver fibrosis measured by transient elastography was significantly associated with a higher risk of incident CKD. Conclusions: Objective: Nonalcoholic fatty liver disease (NAFLD) and chronic kidney disease (CKD) are progressive chronic conditions that share important cardiometabolic risk factors and pathogenic mechanisms. We investigated the association between liver fibrosis and the risk of incident CKD in patients with NAFLD. Methods: A total of 5,983 participants with NAFLD (defined as controlled attenuation parameter >222 dB/m) but without CKD who underwent transient elastography (TE) between March 2012 and August 2018 were selected. The primary outcome was incident CKD, defined as the occurrence of estimated glomerular filtration rate (eGFR) <60 mL/min/1.73 m2 or proteinuria (≥1+ on dipstick test) on two consecutive measurements during follow-up. The secondary outcome was a 25% decline in eGFR measured on two consecutive visits. Results: The mean age was 51.8 years and 3,756 (62.8%) participants were male. During 17,801 person-years of follow-up (mean follow-up of 3.0 years), 62 participants (1.0%) developed incident CKD. When stratified into TE-defined fibrosis stages, multivariable Cox models revealed that risk of incident CKD was 3.63-fold (95% CI, 1.64-8.06, P<0.001) higher in the F3-4 group (≥9.5 kPa), compared to the F0 group (<5.5 kPa). During 17,577 person-years of follow-up (mean follow-up of 3.0 years), 201 participants (3.4%) experienced the secondary outcome, for which the F3-4 group had a 2.69-fold increased risk (95% CI, 1.70-4.27, P<0.001), compared to the F0 group. Conclusions: In this large cohort of NAFLD patients without baseline CKD, advanced liver fibrosis measured by transient elastography was significantly associated with a higher risk of incident CKD.
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