Nonalcoholic Fatty Liver Disease and the Risk of Incident Chronic Kidney Disease: A Meta-Analysis

Nonalcoholic fatty liver disease (NAFLD) is a multisystem disease that affects many extrahepatic-organ systems. In this respect, several studies have suggested the possible association between NAFLD and the risk of incident chronic kidney disease (CKD). However, the extent of this association remains unclear. Thus the present meta-analysis was conducted to better characterize this association. In the meta-analysis, a comprehensive search of the databases of MEDLINE, EMBASE, Web of Science and Cochran Library was carried out from inception through September 2017. All large observational studies that investigated the association between NAFLD and the risk of incident CKD were included. The incident CKD was defined as occurrence of estimated glomerular filtration rate (eGFR) < 60ml/min/1.73m2 and/or overt proteinuria. The pooled hazard ratio (HR) with 95% confidence intervals (CIs) was calculated using the random-effects model. Data were extracted from 5 large observational studies involving 57,341 adult individuals (41.3% with NAFLD) with 1,886 cases of incident CKD. NAFLD is significantly associated with increased risk of incident CKD (HR 1.40, 95%CI 1.22-1.61). The statistical heterogeneity of included studies was low, with an I2=25.4%. In conclusion, the present meta-analysis confirms the association between NAFLD and the risk of incident CKD