title: Nonalcoholic fatty liver is not associated with incident chronic kidney disease: a large histology-based comparison with healthy individuals.
abstract: BACKGROUND
  Nonalcoholic steatohepatitis or fibrosis is associated with the increased prevalence of impaired kidney function. It is not known whether nonalcoholic fatty liver (NAFL), which is steatosis without inflammation or fibrosis, is associated with renal impairment as these individuals are not candidates for liver biopsy.
  
  
  METHODS
  The study group included all liver donors who underwent a preoperative liver biopsy for various reasons. NAFL was defined as more than 5% hepatocytes having steatosis and no changes of steatohepatitis and/or fibrosis. Individuals with NAFL were compared with individuals with normal liver histology. Estimated glomerular filtration rate was calculated with the Modification of Diet in Renal Disease and Chronic Kidney Disease Epidemiology Collaboration methods.
  
  
  RESULTS
  The mean age of the study group was 35±10.3 years and the mean BMI was 26±3.2 kg/m. A total of 187 adults having NAFL (80 men) were compared with 186 (88 men) individuals with normal liver histology (controls). Individuals with steatosis had significantly higher BMI (26.8±3.5 vs. 25.5±3.8 kg/m, P<0.001) and serum alanine transaminase levels (33.8±13.3 vs. 27.2±9.8 IU/l, P<0.000). There was no significant difference in the estimated glomerular filtration rate between the normal histology group and the NAFL group with Modification of Diet in Renal Disease (115±21.8 vs. 114.4±23.2 ml/min, P=0.803) and Chronic Kidney Disease Epidemiology Collaboration methods (113.6±14.8 vs. 113±14.7 ml/min, P=0.668). There was no significant difference as regards serum creatinine (0.73±0.16 vs. 0.74±0.16 mg%, P=0.536), proteinuria (P=0.121), diabetes (1 vs. 4, P=0.372), and hypertension (2 vs. 6, P=0.174) in individuals of both groups.
  
  
  CONCLUSIONS
  Presence of NAFL does not adversely affect renal function.
authors.affiliation: aMedanta Liver Institute bDepartment of Histopathology, Medanta, The Medicity, Gurgaon, Haryana, India.
authors.forename: Narendra S
authors.initials: NS
authors.lastname: Choudhary
authors.forename: Neeraj
authors.initials: N
authors.lastname: Saraf
authors.forename: Naveen
authors.initials: N
authors.lastname: Kumar
authors.forename: Rahul
authors.initials: R
authors.lastname: Rai
authors.forename: Sanjiv
authors.initials: S
authors.lastname: Saigal
authors.forename: Dheeraj
authors.initials: D
authors.lastname: Gautam
authors.forename: Lipika
authors.initials: L
authors.lastname: Lipi
authors.forename: Amit
authors.initials: A
authors.lastname: Rastogi
authors.forename: Sanjay
authors.initials: S
authors.lastname: Goja
authors.forename: Prashant
authors.initials: P
authors.lastname: Bhangui
authors.forename: Sumana K
authors.initials: SK
authors.lastname: Ramchandra
authors.forename: Arvinder S
authors.initials: AS
authors.lastname: Soin
mesh_terms: D000328:Adult; D001706:Biopsy; D005260:Female; D005919:Glomerular Filtration Rate; D006801:Humans; D015994:Incidence; D007194:India / Q000453:epidemiology; D007668:Kidney / Q000503:physiopathology; D008099:Liver / Q000473:pathology; D008297:Male; D008875:Middle Aged; D065626:Non-alcoholic Fatty Liver Disease / Q000175:diagnosis / Q000453:epidemiology* / Q000473:pathology; D011237:Predictive Value of Tests; D051436:Renal Insufficiency, Chronic / Q000175:diagnosis / Q000453:epidemiology* / Q000503:physiopathology; D012189:Retrospective Studies; D012307:Risk Factors