title: Non-alcoholic fatty liver disease: an emerging driving force in chronic kidney disease.
abstract: Non-alcoholic fatty liver disease (NAFLD) is caused by an accumulation of fat in the liver; the condition can progress over time to increase the risk of developing cirrhosis, end-stage liver disease and hepatocellular carcinoma. The prevalence of NAFLD is increasing rapidly owing to the global epidemics of obesity and type 2 diabetes mellitus (T2DM), and NAFLD has been predicted to become the most important indication for liver transplantation over the next decade. It is now increasingly clear that NAFLD not only affects the liver but can also increase the risk of developing extra-hepatic diseases, including T2DM, cardiovascular disease and chronic kidney disease (CKD), which have a considerable impact on health-care resources. Accumulating evidence indicates that NAFLD exacerbates insulin resistance, predisposes to atherogenic dyslipidaemia and releases a variety of proinflammatory factors, prothrombotic factors and profibrogenic molecules that can promote vascular and renal damage. Furthermore, communication or 'crosstalk' between affected organs or tissues in these diseases has the potential to further harm function and worsen patient outcomes, and increasing amounts of evidence point to a strong association between NAFLD and CKD. Whether a causal relationship between NAFLD and CKD exists remains to be definitively established.
authors.affiliation: Division of Endocrinology, Diabetes and Metabolism, Department of Medicine, University and Azienda Ospedaliera Universitaria Integrata of Verona, Piazzale Stefani 1, 37126 Verona, Italy.
authors.forename: Giovanni
authors.initials: G
authors.lastname: Targher
authors.affiliation: Nutrition and Metabolism, Faculty of Medicine, University of Southampton.|Southampton National Institute for Health Research Biomedical Research Centre, University Hospital Southampton, Southampton General Hospital, Tremona Road, Southampton SO16 6YD, UK.
authors.forename: Christopher D
authors.initials: CD
authors.lastname: Byrne
mesh_terms: D003924:Diabetes Mellitus, Type 2 / Q000209:etiology; D042783:Endothelial Cells / Q000502:physiology; D000069196:Gastrointestinal Microbiome; D006801:Humans; D065626:Non-alcoholic Fatty Liver Disease / Q000150:complications* / Q000453:epidemiology / Q000628:therapy; D015995:Prevalence; D051436:Renal Insufficiency, Chronic / Q000209:etiology*