Increased risk of CKD among type 2 diabetics with nonalcoholic fatty liver disease - PubMed (original) (raw)

Increased risk of CKD among type 2 diabetics with nonalcoholic fatty liver disease

Giovanni Targher et al. J Am Soc Nephrol. 2008 Aug.

Abstract

It is unknown whether chronic kidney disease (CKD) is associated with nonalcoholic fatty liver disease among patients with type 2 diabetes. We followed 1760 outpatients with type 2 diabetes and normal or near-normal kidney function and without overt proteinuria for 6.5 yr for the occurrence of CKD (defined as overt proteinuria and/or estimated GFR <60 ml/min per 1.73 m(2)). During follow-up, 547 participants developed incident CKD. Nonalcoholic fatty liver disease, diagnosed by liver ultrasound and exclusion of other common causes of chronic liver disease, was associated with a moderately increased risk for CKD (hazard ratio 1.69; 95% confidence interval 1.3 to 2.6; P < 0.001). Adjustments for gender, age, body mass index, waist circumference, BP, smoking, diabetes duration, glycosylated hemoglobin, lipids, baseline estimated GFR, microalbuminuria, and medications (hypoglycemic, lipid-lowering, antihypertensive, or antiplatelet drugs) did not appreciably attenuate this association (hazard ratio 1.49; 95% confidence interval 1.1 to 2.2; P < 0.01). In conclusion, our findings suggest that nonalcoholic fatty liver disease is associated with an increased incidence of CKD in individuals with type 2 diabetes, independent of numerous baseline confounding factors.

PubMed Disclaimer

Figures

Figure 1.

Figure 1.

Details of the study design. 1760 participants attending the follow-up examinations were included in the final analysis.

Figure 2.

Figure 2.

Cumulative proportions of patients who had type 2 diabetes and developed CKD during follow-up, stratified by NAFLD status.

Similar articles

Cited by

References

    1. Mogensen CE, Cooper ME: Diabetic renal disease: From recent studies to improved clinical practice. Diabet Med 21: 4–17, 2004 - PubMed
    1. Rossing P: Prediction, progression and prevention of diabetic nephropathy. The Minkowski Lecture 2005. Diabetologia 49: 11–19, 2006 - PubMed
    1. Rossing P: Diabetic nephropathy: Worldwide epidemic and effects of current treatment on natural history. Curr Diab Rep 6: 479–483, 2006 - PubMed
    1. Lewis EJ: Treating hypertension in the patient with overt diabetic nephropathy. Semin Nephrol 27: 182–194, 2007 - PubMed
    1. Strippoli GF, Bonifati C, Craig M, Navaneethan SD, Craig JC: Angiotensin converting enzyme inhibitors and angiotensin II receptor antagonists for preventing the progression of diabetic kidney disease. Cochrane Database Syst Rev 4: CD006257, 2006 - PMC - PubMed

MeSH terms

LinkOut - more resources