title: The development of chronic kidney disease in Japanese patients with non-alcoholic fatty liver disease.
abstract: Objective Chronic kidney disease (CKD) is present in patients with nonalcoholic fatty liver disease (NAFLD). The aim of this retrospective study was to assess the cumulative development incidence and predictive factors for new onset of CKD in Japanese patients with NAFLD. Methods A total of 5,561 NAFLD patients without CKD were enrolled. CKD was defined as either an estimated glomerular filtration rate of <60 mL/min/1.73 m(2) or dipstick proteinuria (≥+1). A blood sample and a urine sample were taken for routine analyses during follow-up. The mean observation period was 5.5 years. The primary goal is the new development of CKD. Independent factors associated with new development of CKD were analyzed by using the Kaplan-Meyer method and the Cox proportional hazards model. Results Of 5.561 NAFLD patients, 263 patients developed CKD. The cumulative development rate of CKD was 3.1% at the 5th year and 12.2% at the 10th year. Multivariate Cox proportional hazards analysis showed that CKD development in patients with NAFLD occurred when patient had low level of GFR of 60-75 mL/min/1.73 m(2) [hazard ratio:2.75; 95% confidence interval (CI)=1.93-3.94; p<0.001], age of ≥50 years (hazard ratio: 2.67; 95% CI=2.06-3.46; p<0.001), diabetes (hazard ratio: 1.92; 95% CI=1.45-2.54; p<0.001), hypertension (hazard ratio: 1.69; 95% CI=1.25-2.29; p<0.001), and elevated serum gamma-glutamyltransferase of ≥109 IU/L (hazard ratio: 1.35; 95% CI=1.02-1.78; p=0.038). Conclusion Our retrospective study indicates that the annual incidence of CKD in Japanese patients with NAFLD is about 1.2%. Five factors of low eGFR level, aging, type 2 diabetes, hypertension, and elevated gamma-glutamyltransferase, increases the risk of the development of CKD.
authors.affiliation: Department of Hepatology and Okinaka Memorial Institute for Medical Research, Toranomon Hospital, Japan. es9y-ars@asahi-net.or.jp
authors.forename: Yasuji
authors.initials: Y
authors.lastname: Arase
authors.forename: Fumitaka
authors.initials: F
authors.lastname: Suzuki
authors.forename: Mariko
authors.initials: M
authors.lastname: Kobayashi
authors.forename: Yoshiyuki
authors.initials: Y
authors.lastname: Suzuki
authors.forename: Yusuke
authors.initials: Y
authors.lastname: Kawamura
authors.forename: Naoki
authors.initials: N
authors.lastname: Matsumoto
authors.forename: Norio
authors.initials: N
authors.lastname: Akuta
authors.forename: Masahiro
authors.initials: M
authors.lastname: Kobayashi
authors.forename: Hitomi
authors.initials: H
authors.lastname: Sezaki
authors.forename: Satoshi
authors.initials: S
authors.lastname: Saito
authors.forename: Tetsuya
authors.initials: T
authors.lastname: Hosaka
authors.forename: Kenji
authors.initials: K
authors.lastname: Ikeda
authors.forename: Hiromitsu
authors.initials: H
authors.lastname: Kumada
authors.forename: Yuki
authors.initials: Y
authors.lastname: Ohmoto
authors.forename: Kazuhisa
authors.initials: K
authors.lastname: Amakawa
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Tsuji
authors.forename: Shiun Dong
authors.initials: SD
authors.lastname: Hsieh
authors.forename: Kazuhisa
authors.initials: K
authors.lastname: Kato
authors.forename: Maho
authors.initials: M
authors.lastname: Tanabe
authors.forename: Kyoko
authors.initials: K
authors.lastname: Ogawa
authors.forename: Shigeko
authors.initials: S
authors.lastname: Hara
authors.forename: Tetsuro
authors.initials: T
authors.lastname: Kobayashi
mesh_terms: D000328:Adult; D000367:Age Factors; D044466:Asian People; D015331:Cohort Studies; D003924:Diabetes Mellitus, Type 2 / Q000150:complications; D005234:Fatty Liver / Q000150:complications* / Q000503:physiopathology; D005260:Female; D005919:Glomerular Filtration Rate; D006801:Humans; D006973:Hypertension / Q000150:complications; D015994:Incidence; D007564:Japan / Q000453:epidemiology; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D065626:Non-alcoholic Fatty Liver Disease; D016016:Proportional Hazards Models; D051436:Renal Insufficiency, Chronic / Q000453:epidemiology / Q000209:etiology* / Q000503:physiopathology; D012189:Retrospective Studies; D012307:Risk Factors; D005723:gamma-Glutamyltransferase / Q000097:blood
chemical_list: D005723:gamma-Glutamyltransferase