- Moderate to advanced-stage chronic kidney disease (CKD) is an independent predictor of early death among patients with nonalcoholic fatty liver disease (NAFLD).
Why this matters
- This population study clearly links NAFLD and CKD; patients at risk for adverse outcomes should be identified and managed appropriately.
- Study of 11,695 individuals (mean age, 43.3 years; 48.4% male; 76.4% white) in NHANES-III (1988-1994) with linked mortality data.
- 6.8% had CKD, 16.1% had NAFLD, 2.5% had NAFLD+CKD, and 74.6% had neither condition.
- Funding: None.
- Individuals with NAFLD+CKD were more likely to be older, have less income, and have additional comorbidities (all P<.05 than those with neither condition.>
- Age-adjusted CKD prevalence in NAFLD was 11.31%; most cases were stage I (6.1%), II (3.7%), or IIIa (2.8%).
- Overall and cardiovascular disease (CVD) mortality rates in NAFLD+CKD were 54.69% and 16.03%, respectively, over a mean of 19.2 years.
- In multivariate analysis, risk for overall death was higher in NAFLD+CKD (aHR=2.34; P<.05 than ckd alone p vs neither.>
- In NAFLD, mortality risk increased by CKD stage:
- Overall mortality: stages II-IIIa (aHR=2.31; P<.0001 vs iiib-v p>
- CVD mortality: stages II-IIIa (aHR=2.06; P=.0150) vs IIIb-V (aHR=6.04; P=.0003).
- NAFLD prevalence potentially underestimated.
- Cross-sectional analysis.