CROSSTALK BETWEEN NAFLD AND CKD AND ITS EFFECT ON EGFR

Introduction:- NAFLD and CKD are associated with poor outcomes and high costs they have become major public health problems owing to their increasing prevalence and incidence. The present study is determined to establish the association between NAFLD and CKD by studying the effect of NAFLD on eGFR.

Material and Methods:- This prospective observational study was conducted at MLN Medical College, SRN hospital, Prayagraj and Tejas Microdiagnostics. A total of 800 newly diagnosed CKD patients were enrolled. Among CKD patients NAFLD was diagnosed by USG whole abdomen, degree of steatosis, and severity was accessed by FIB-4 score. Renal function of the CKD patients was examined at the beginning of the study and six monthly follow up of serum creatinine was done. Study was completed after 18 months.

Results:- Out of 800 CKD patients, 600 patients were diagnosed with NAFLD while 200 patients did not show any symptom of NAFLD. These 200 patients were taken as control. A significant increase in serum creatinine and significant decline of eGFR was noted. CKD patients with NAFLD have significantly higher FIB-4 score than patients without NAFLD. Patients with high FIB-4 score (> 1.1) had significant decline of eGFR while in patients without NAFLD, decline of eGFR was not statistically significant.

Conclusion:- The findings of the study clearly establish a high prevalence of NAFLD in CKD patients and their impact on the renal functions. After excluding the other causes of CKD and Fatty liver disease, NAFLD can be considered as an independent risk factor of CKD.