Increased prevalence of chronic kidney disease in patients with Type 1 diabetes and non-alcoholic fatty liver
Version of Record online: 11 JAN 2012
© 2012 The Authors. Diabetic Medicine © 2012 Diabetes UK
Volume 29, Issue 2, pages 220–226, February 2012
How to Cite
Targher, G., Pichiri, I., Zoppini, G., Trombetta, M. and Bonora, E. (2012), Increased prevalence of chronic kidney disease in patients with Type 1 diabetes and non-alcoholic fatty liver. Diabetic Medicine, 29: 220–226. doi: 10.1111/j.1464-5491.2011.03427.x
- Issue online: 11 JAN 2012
- Version of Record online: 11 JAN 2012
- Accepted manuscript online: 26 AUG 2011 09:41PM EST
- Accepted 19 August 2011
- chronic kidney disease;
- liver fat;
- non-alcoholic fatty liver;
- metabolic syndrome;
- Type 1 diabetes
Diabet. Med. 29, 220–226 (2012)
Aims We determined whether non-alcoholic fatty liver is associated with an increased prevalence of chronic kidney disease in Type 1 diabetes.
Methods We studied 343 patients with Type 1 diabetes, who had no history of excessive alcohol consumption or other secondary causes of chronic liver disease. Non-alcoholic fatty liver was diagnosed by ultrasonography. Chronic kidney disease was defined as presence of either abnormal albuminuria (i.e. urinary albumin/creatinine ratio ≥ 30 mg/g) or estimated glomerular filtration rate of less than 60 ml min−1 1.73 m−2.
Results Compared with those without steatosis, patients with non-alcoholic fatty liver (n = 182) had significantly lower estimated GFR (83.0 ± 27 vs. 93.3 ± 29 ml min−1 1.73 m−2, P < 0.001) and a greater prevalence of abnormal albuminuria (50.0 vs. 20.5%, P < 0.0001) and chronic kidney disease (54.4 vs. 24.2%, P < 0.0001). Multivariable logistic regression analysis revealed that non-alcoholic fatty liver was associated with an increased risk of either abnormal albuminuria (adjusted odds ratio 2.21, 95% CI 1.2–4.1, P = 0.01) or chronic kidney disease (adjusted odds ratio 1.93, 95% CI 1.1–3.6, P = 0.02), independently of age, gender, smoking status, physical activity, diabetes duration, HbA1c, BMI, systolic blood pressure, plasma lipids and use of anti-hypertensive and lipid-lowering medications.
Conclusions Our findings demonstrate that ultrasound-diagnosed non-alcoholic fatty liver is associated with a higher prevalence of chronic kidney disease in patients with Type 1 diabetes, independently of several risk factors, including the components of the metabolic syndrome.