Non-alcoholic fatty liver disease increases the risk of incident chronic kidney disease
Non-alcoholic fatty liver disease increases the risk of incident chronic kidney disease
复制标题
DOI：
10.1177/2050640620944098
复制
发表时间：
2020-07-23
影响因子：
6
通讯作者：
Schattenberg, Joern M.
中科院分区：
文献类型：
--
作者：
Kaps, Leonard;Labenz, Christian;Schattenberg, Joern M.
背景和目的非酒精性脂肪肝（NAFLD）是一种高度流行的慢性肝脏疾病。其在肝外合并症发生中的作用正在研究中。NAFLD对慢性肾脏病（CKD）发展的影响尚不完全清楚。本研究的目的是探讨德国NAFLD对CKD的潜在影响。方法对2000年至2015年期间诊断为NAFLD的患者进行了疾病分析仪数据库（涵盖德国的749万例病例）研究，并与非NAFLD队列进行1：1匹配。匹配标准包括年龄、性别、医生、索引年和与CKD相关的合并诊断。本研究的主要结局是CKD和终末期肾病的发生率。结果共48，057例NAFLD患者与48，057例非NAFLD患者匹配。在索引日期的10年内，17.1%的NAFLD患者和11.6%的非NAFLD患者被诊断为CKD（p < 0.001）。经考克斯回归分析，NAFLD与CKD发病率显著相关（HR = 1.58，p < 0.001）。这种关联在不同年龄组和亚组（如糖尿病或动脉高血压患者）中仍然显著。NAFLD与透析治疗无相关性（HR = 1.25，p = 0.245）。结论在德国的大型数据库分析中，NAFLD构成CKD的独立危险因素。应监测NAFLD患者的肾功能变化，以促进早期肾脏疾病的治疗措施。
Background and aim Non-alcoholic fatty liver disease (NAFLD) is a highly prevalent chronic liver disease. Its role in the development of extrahepatic co-morbidities is under investigation. The impact of NAFLD on the development of chronic kidney disease (CKD) is incompletely understood. The aim of this study was to explore the potential contribution of NAFLD on CKD in Germany. Methods The Disease Analyzer Database covering 7.49 million cases in Germany was explored for patients diagnosed with NAFLD between 2000 and 2015 and was matched 1:1 to a cohort without NAFLD. Matching criteria included age, sex, physician, index year and co-diagnoses associated with CKD. The primary outcomes of this study were incidences of CKD and end-stage renal disease. Results A total of 48,057 patients with NAFLD were matched to 48,057 patients without NAFLD. Within 10 years of the index date, 17.1% of patients with NAFLD and 11.6% of patients without NAFLD were diagnosed with CKD (p < 0.001). On Cox regression analysis, NAFLD was significantly associated with the incidence of CKD (hazard ratio (HR) = 1.58,p < 0.001). This association remained significant across different age groups and subgroups such as patients with diabetes mellitus or arterial hypertension. There was no association between NAFLD and emerging dialysis therapy (HR = 1.25,p = 0.245). Conclusions In this large database analysis in Germany, NAFLD constitutes an independent risk factor for CKD. Patients living with NAFLD should be monitored for a change in kidney function, facilitating therapeutic measures for kidney disease at an early stage.