Prevalence of non-alcoholic fatty liver disease in patients with chronic kidney disease: a cross-sectional study

BACKGROUND: Non-alcoholic fatty liver disease (NAFLD) is the most common liver disease and represents a wide spectrum ranging from mild steatosis to non-alcoholic steatohepatitis with or without fibrosis to overt cirrhosis. Patients with NAFLD have a high risk of developing cardiovascular disease and chronic kidney disease (CKD). So far there has been scarce evidence of the prevalence of NAFLD among patients with CKD. We investigated the prevalence of moderate-severe hepatic steatosis graded according to the definition of NAFLD in a cohort of patients with CKD.

METHODS: Hepatic liver fat content was evaluated by computed tomography (CT) scan in 291 patients from the Copenhagen CKD Cohort Study and in 866 age- and sex-matched individuals with normal kidney function from the Copenhagen General Population Study. Liver attenuation density <48 HU was used as a cut-off value for moderate-severe hepatic steatosis.

RESULTS: The prevalence of moderate-severe hepatic steatosis was 7.9 and 10.7% (P = 0.177) among patients with CKD and controls, respectively. No association between liver fat content and CKD stage was found. In the pooled dataset from both cohorts, adjusted odds ratios for moderate-severe hepatic steatosis among persons with diabetes, overweight and obesity were 3.1 [95% confidence interval (CI) 1.6-5.9], 14.8 (95% CI 4.6-47.9) and 42.0 (95% CI 12.9-136.6), respectively.

CONCLUSIONS: In a cohort of 291 patients with CKD, kidney function was not associated with the prevalence of moderate-severe hepatic steatosis as assessed by CT scan.