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Concurrence of HBV infection and non-alcoholic fatty liver disease is associated with higher prevalence of chronic kidney disease - 20/04/21

Doi : 10.1016/j.clinre.2020.06.009 
Su Lin a, Mingfang Wang b, Yuxiu Liu b, Jiaofeng Huang b, Yinlian Wu b, Yueyong Zhu b, Xiaozhong Wang a,
a Department of Gastroenterology, Union Hospital of Fujian Medical University, Fuzhou, Fujian 
b Liver Research Center of the First Affiliated Hospital of Fujian Medical University, Fuzhou, Fujian, 350000, China 

Corresponding author at: Department of Gastroenterology, Union Hospital of Fujian Medical University, Fuzhou, Fujian, China.Department of Gastroenterology, Union Hospital of Fujian Medical University, FuzhouFujianChina

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Highlights

This population-based study accessed the impact of HBV infection and /or non-alcoholic fatty liver disease (NAFLD) on chronic kidney disease (CKD). The results showed:.
Both HBV-infection and NAFLD increase the risk of CKD.
The impact of HBV-infection on kidney is stronger than NAFLD.
Co-existence of HBV-infection and NAFLD increased the risk of CKD by 2-fold compared to patients without liver disease,
Monitoring and control of CKD in patients with chronic liver disease are strongly recommended.

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Summary

Aims

Coexistence of non-alcoholic fatty liver disease (NAFLD) and hepatitis B virus (HBV) infection is common in clinical practice. This study was to explore the prevalence of chronic kidney disease (CKD) in patients with NAFLD and/or HBV.

Methods

Participants who received health examination in a physical examination center were included in this cross-sectional study. Binary logistic regression was used to estimate the odds ratios (ORs) for CKD.

Results

A total of 32,578 cases were included in the final analysis, with 52.3% males and an average age of 44.01±13.09 years old. The positive rate of HBV surface antigen was 14.5% and NAFLD was diagnosed in 30.2% cases. The coexistence of NAFLD and HBV-infection was found in 1,275 (3.9%) cases. In overall population, 713 (2.2%) cases were diagnosed with CKD. The CKD prevalence were 1.4%, 2.1%, 3.5% and 5.0% in those without NAFLD or HBV, HBV-infection alone, NAFLD alone and those with concomitant HBV-infection and NAFLD, respectively. After adjustment for age, sex, body mass index, diabetes and hypertension, the correlation between CKD and liver disease was still significant in HBV group (OR=1.388, 95%CI: 1.055–1.809), yet no longer existed in patients with NAFLD (OR=1.183, 95%CI: 0.986–1.420). The concomitant of NAFLD and HBV infection was associated with a higher odds ratio for CKD compared to any other group (OR=1.961, 95%CI=1.454–2.645).

Conclusions

The coexistence of NAFLD and HBV increases the risk of CKD by 2-fold. The control of multiple liver diseases will be beneficial not only to liver but also to kidney.

Il testo completo di questo articolo è disponibile in PDF.

Keywords : Non-alcoholic fatty liver disease, Hepatitis B virus, Chronic kidney disease


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