Association of non-alcoholic fatty liver disease with chronic kidney disease: a systematic review and meta-analysis

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Association of non-alcoholic fatty liver disease with chronic kidney disease : a systematic review and meta-analysis

Musso, G. (författare): Gradenigo Hospital, University of Turin, Turin, Italy

Gambino, R. (författare): Dept. of Medical Sciences, San Giovanni Battista Hospital, University of Turin, Turin, Italy

Tabibian, J.H. (författare): Karolinska Institutet,Division of Gastroenterology and Hepatology Mayo Clinic, Rochester, MN, United States,Departments of Gastroenterology and Hepatology, Karolinska University Hospital, Karolinska Institutet, Stockholm, Sweden

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Ekstedt, Mattias (författare): Östergötlands Läns Landsting,Linköpings universitet,Avdelningen för inflammationsmedicin,Hälsouniversitetet,Magtarmmedicinska kliniken

Kechagias, Stergios (författare): Östergötlands Läns Landsting,Linköpings universitet,Avdelningen för kardiovaskulär medicin,Hälsouniversitetet,Magtarmmedicinska kliniken,Division of Hepato-Gastroenterology, Department of Internal Medicine, Kangnam St. Mary Hospital, Catholic University Medical College, Seoul, South Korea

Hamaguchi, M. (författare): Department of Experimental Immunology, World Premier International Immunology Frontier Research Center, Osaka University, Osaka, Japan

Hultcrantz, R. (författare): Karolinska Institutet,Departments of Gastroenterology and Hepatology, Karolinska University Hospital, Karolinska Institutet, Stockholm, Sweden

Hagstrom, H. (författare): Departments of Gastroenterology and Hepatology, Karolinska University Hospital, Karolinska Institutet, Stockholm, Sweden,Institute for Community Medicine, Ernst-Moritz-Arndt University Medicine Greifswald, Greifswald, Germany,Department of Gastroenterology, University Hospital of Santa Maria, Institute of Molecular Medicine, Lisbon, Portugal

Yoon, S.K. (författare): Division of Hepato-Gastroenterology, Department of Internal Medicine, Kangnam St. Mary Hospital, Catholic University Medical College, Seoul, South Korea

Charatcharoenwitthaya, P. (författare): Division of Gastroenterology, Medicine Department, Siriraj Hospital, Mahidol University, Bangkoknoi, Bangkok, Thailand

George, J. (författare): Storr Liver Unit, Westmead Millennium Institute, University of Sydney and Department of Gastroenterology and Hepatology, Westmead Hospital, Westmead, NSW, Australia

Barrera, F. (författare): Storr Liver Unit, Westmead Millennium Institute, University of Sydney and Department of Gastroenterology and Hepatology, Westmead Hospital, Westmead, NSW, Australia

Haflidadottir, S. (författare): Dept of Gastroenterology and Hepatology, Landspitali University Hospital, Hringbrau, Reykjavik, Iceland

Bjornsson, E.S. (författare): Dept of Gastroenterology and Hepatology, Landspitali University Hospital, Hringbrau, Reykjavik, Iceland

Armstrong, M.J. (författare): Centre for Liver Research and NIHR Biomedical Research Unit in Liver Disease, Institute of Biomedical Research, University of Birmingham, Birmingham, United Kingdom,Department of Gastroenterology, University Hospital of Santa Maria, Institute of Molecular Medicine, Lisbon, Portugal

Hopkins, L.J. (författare): Centre for Liver Research and NIHR Biomedical Research Unit in Liver Disease, Institute of Biomedical Research, University of Birmingham, Birmingham, United Kingdom

Gao, X. (författare): Department of Endocrinology and Metabolism, Zhongshan Hospital, Fudan University, Shanghai, China

Francque, S. (författare): Department of Gastroenterology and Hepatology, Antwerp University Hospital, University of Antwerp, Antwerp, Belgium

Verrijken, A. (författare): Department of Endocrinology, Diabetology and Metabolism, Antwerp University Hospital, University of Antwerp, Antwerp, Belgium

Yilmaz, Y. (författare): Department of Gastroenterology, Marmara University, School of Medicine, Istanbul, Turkey

Lindor, K.D. (författare): Division of Gastroenterology and Hepatology Mayo Clinic, Rochester, MN, United States

Charlton, M. (författare): Division of Gastroenterology and Hepatology Mayo Clinic, Rochester, MN, United States

Haring, R. (författare): Institute of Clinical Chemistry and Laboratory Medicine, Ernst-Moritz-Arndt University Greifswald, Greifswald, Germany

Lerch, M.M. (författare): Department of Medicine A, University Medicine Greifswald, Greifswald, Germany

Rettig, R. (författare): Institute of Physiology, Ernst-Moritz-Arndt-University Medicine Greifswald, Karlsburg, Germany

Volzke, H. (författare): Institute for Community Medicine, Ernst-Moritz-Arndt University Medicine Greifswald, Greifswald, Germany

Ryu, S. (författare): Department of Occupational and Environmental Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University, School of Medicine, Seoul, South Korea

Li, G. (författare): College of Life Sciences, Hunan Normal University, Changsha, China

Wong, L.L. (författare): John A. Burns School of Medicine at University of Hawaii, Transplant Institute, Hawaii Medical Center, Honolulu, HI, United States

Machado, M. (författare): Department of Gastroenterology, University Hospital of Santa Maria, Institute of Molecular Medicine, Lisbon, Portugal,Dept. of Medical Sciences, San Giovanni Battista Hospital, University of Turin, Turin, Italy

Cortez-Pinto, H. (författare): Department of Gastroenterology, University Hospital of Santa Maria, Institute of Molecular Medicine, Lisbon, Portugal

Yasui, K. (författare): Department of Molecular Gastroenterology and Hepatology, Kyoto Prefectural University of Medicine, Japan

Cassader, M. (författare): Dept. of Medical Sciences, San Giovanni Battista Hospital, University of Turin, Turin, Italy

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Gradenigo Hospital, University of Turin, Turin, Italy Dept of Medical Sciences, San Giovanni Battista Hospital, University of Turin, Turin, Italy (creator_code:org_t)

2014-07-22
2014
Engelska.
Ingår i: PLoS Medicine. - : Public Library of Science. - 1549-1277 .- 1549-1676. ; 11:7, s. e1001680-

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Background:Chronic kidney disease (CKD) is a frequent, under-recognized condition and a risk factor for renal failure and cardiovascular disease. Increasing evidence connects non-alcoholic fatty liver disease (NAFLD) to CKD. We conducted a meta-analysis to determine whether the presence and severity of NAFLD are associated with the presence and severity of CKD.Methods and Findings:English and non-English articles from international online databases from 1980 through January 31, 2014 were searched. Observational studies assessing NAFLD by histology, imaging, or biochemistry and defining CKD as either estimated glomerular filtration rate (eGFR) andlt;60 ml/min/1.73 m2 or proteinuria were included. Two reviewers extracted studies independently and in duplicate. Individual participant data (IPD) were solicited from all selected studies. Studies providing IPD were combined with studies providing only aggregate data with the two-stage method. Main outcomes were pooled using random-effects models. Sensitivity and subgroup analyses were used to explore sources of heterogeneity and the effect of potential confounders. The influences of age, whole-body/abdominal obesity, homeostasis model of insulin resistance (HOMA-IR), and duration of follow-up on effect estimates were assessed by meta-regression. Thirty-three studies (63,902 participants, 16 population-based and 17 hospital-based, 20 cross-sectional, and 13 longitudinal) were included. For 20 studies (61% of included studies, 11 cross-sectional and nine longitudinal, 29,282 participants), we obtained IPD. NAFLD was associated with an increased risk of prevalent (odds ratio [OR] 2.12, 95% CI 1.69-2.66) and incident (hazard ratio [HR] 1.79, 95% CI 1.65-1.95) CKD. Non-alcoholic steatohepatitis (NASH) was associated with a higher prevalence (OR 2.53, 95% CI 1.58-4.05) and incidence (HR 2.12, 95% CI 1.42-3.17) of CKD than simple steatosis. Advanced fibrosis was associated with a higher prevalence (OR 5.20, 95% CI 3.14-8.61) and incidence (HR 3.29, 95% CI 2.30-4.71) of CKD than non-advanced fibrosis. In all analyses, the magnitude and direction of effects remained unaffected by diabetes status, after adjustment for other risk factors, and in other subgroup and meta-regression analyses. In cross-sectional and longitudinal studies, the severity of NAFLD was positively associated with CKD stages. Limitations of analysis are the relatively small size of studies utilizing liver histology and the suboptimal sensitivity of ultrasound and biochemistry for NAFLD detection in population-based studies.Conclusion:The presence and severity of NAFLD are associated with an increased risk and severity of CKD.Please see later in the article for the Editors Summary. © 2014 Musso et al.

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MEDICIN OCH HÄLSOVETENSKAP: MEDICIN OCH HÄLS ...; och Klinisk medicin

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Av lärosätet: Linköpings universitet; Karolinska Institutet

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Association of non-alcoholic fatty liver disease with chronic kidney disease : a systematic review and meta-analysis

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