title: The Impact of Nonalcoholic Fatty Liver Disease on Renal Function in Children with Overweight/Obesity.
abstract: The association between nonalcoholic fatty liver disease (NAFLD) and chronic kidney disease has attracted interest and attention over recent years. However, no data are available in children. We determined whether children with NAFLD show signs of renal functional alterations, as determined by estimated glomerular filtration rate (eGFR) and urinary albumin excretion. We studied 596 children with overweight/obesity, 268 with NAFLD (hepatic fat fraction ≥5% on magnetic resonance imaging) and 328 without NAFLD, and 130 healthy normal-weight controls. Decreased GFR was defined as eGFR < 90 mL/min/1.73 m². Abnormal albuminuria was defined as urinary excretion of ≥30 mg/24 h of albumin. A greater prevalence of eGFR < 90 mL/min/1.73 m² was observed in patients with NAFLD compared to those without liver involvement and healthy subjects (17.5% vs. 6.7% vs. 0.77%; p < 0.0001). The proportion of children with abnormal albuminuria was also higher in the NAFLD group compared to those without NAFLD, and controls (9.3% vs. 4.0% vs. 0; p < 0.0001). Multivariate logistic regression analysis revealed that NAFLD was associated with decreased eGFR and/or microalbuminuria (odds ratio, 2.54 (confidence interval, 1.16-5.57); p < 0.05) independently of anthropometric and clinical variables. Children with NAFLD are at risk for early renal dysfunction. Recognition of this abnormality in the young may help to prevent the ongoing development of the disease.
authors.affiliation: Policlinico Umberto I Hospital, Sapienza University of Rome, Viale Regina Elena 324, 00161 Rome, Italy. lucia.pacifico@uniroma1.it.
authors.forename: Lucia
authors.initials: L
authors.lastname: Pacifico
authors.affiliation: Department of Experimental Medicine, Sapienza University of Rome, Viale Regina Elena 324, 00161 Rome, Italy. enea.bonci@uniroma1.it.
authors.forename: Enea
authors.initials: E
authors.lastname: Bonci
authors.affiliation: Policlinico Umberto I Hospital, Sapienza University of Rome, Viale Regina Elena 324, 00161 Rome, Italy. gianmarcoandreoli@gmail.com.
authors.forename: Gian Marco
authors.initials: GM
authors.lastname: Andreoli
authors.affiliation: Department of Radiological Sciences, Sapienza University of Rome, Viale Regina Elena 324, 00161 Rome, Italy. micdimartino@hotmail.it.
authors.forename: Michele
authors.initials: M
authors.lastname: Di Martino
authors.affiliation: Policlinico Umberto I Hospital, Sapienza University of Rome, Viale Regina Elena 324, 00161 Rome, Italy. alessia.gallozzi@gmail.com.
authors.forename: Alessia
authors.initials: A
authors.lastname: Gallozzi
authors.affiliation: Policlinico Umberto I Hospital, Sapienza University of Rome, Viale Regina Elena 324, 00161 Rome, Italy. esterdeluca91@libero.it.
authors.forename: Ester
authors.initials: E
authors.lastname: De Luca
authors.affiliation: Institute of Translational Pharmacology, National Research Council, Via Fosso del Cavaliere 100, 00133 Rome, Italy. claudio.chiesa@ift.cnr.it.
authors.forename: Claudio
authors.initials: C
authors.lastname: Chiesa
mesh_terms: D016022:Case-Control Studies; D002648:Child; D003430:Cross-Sectional Studies; D005260:Female; D005919:Glomerular Filtration Rate; D006801:Humans; D008297:Male; D065626:Non-alcoholic Fatty Liver Disease / Q000503:physiopathology*; D009765:Obesity / Q000150:complications*; D050177:Overweight / Q000150:complications*; D015995:Prevalence; D051436:Renal Insufficiency, Chronic / Q000453:epidemiology*; D012307:Risk Factors; D012384:Rome / Q000453:epidemiology
keywords: children; nonalcoholic fatty liver disease; obesity; renal function