A higher FIB‐4 index is associated with an increased incidence of renal failure in the general population

Abstract

The Fibrosis‐4 index (FIB‐4) is a recommended noninvasive fibrosis test in patients at risk of liver fibrosis. Chronic liver diseases are often associated with kidney diseases. This study aimed to investigate the association between FIB‐4 and the development of renal failure among the general population. For this study, we used the Disease Analyzer database, which includes diagnoses and basic medical and demographic data of patients followed in general practices in Germany. Using these data, we extensively matched patients with a FIB‐4 index ≥ 1.3 (n = 66,084) to patients with a FIB‐4 index < 1.3 (n = 66,084). The primary outcome was the incidence of renal failure or chronic renal failure during a 10‐year period. Within 10 years of the index date, 9.2% of patients with a FIB‐4 < 1.3 and 10.6% of patients with a FIB‐4 ≥ 1.3 were diagnosed with renal failure (p = 0.007). The endpoint chronic renal failure was reached by 7.9% with a FIB‐4 < 1.3 and 9.5% with a FIB‐4 ≥ 1.3 (p < 0.001). A FIB‐4 index ≥ 1.3 was associated with a slight increase in renal failure incidence (hazard ratio [HR]: 1.08, p = 0.009). There was an increasing association between an increase in FIB‐4 index and the incidence of renal failure with the strongest association for a FIB‐4 index ≥ 2.67 (HR: 1.34, p = 0.001). In sensitivity analyses, a significant association was found for the age group of 51–60 years (HR: 1.38, p < 0.001), patients with arterial hypertension (HR: 1.15, p < 0.001), obese patients (HR: 1.25, p = 0.005), and patients with lipid metabolism disorders (HR:1.22, p < 0.001). Conclusion: A higher FIB‐4 index is associated with an increased incidence of renal failure. Therefore, the FIB‐4 index may be useful in identifying patients who are at risk not only for liver‐related events but also for renal disease.

Higher FIB-4 index at baseline predicts development of liver cancer in a community-based cohort with viral hepatitis

“…A regional core center can also recommend intensive follow-up for individuals with changes in their FIB-4 index over time that suggest progression of liver fibrosis. An elevated FIB-4 index has recently been reported to be related to the following: an increased risk of cardiovascular events, cardiovascular mortality, and allcause mortality in patients with cardiovascular disease (30); severity of illness and mortality in patients with COVID-19 (31); and an increased incidence of renal failure (32) and depression (33). The FIB-4 index can be calculated easily for individuals who attend regular follow-ups, so could be used not only for screening patients for liver disease but also for non-liver diseases as part of regular wellness checks.…”

The Roles of Liver Fibrosis Scores and Modified Stress Hyperglycemia Ratio Values in Predicting Contrast-Induced Nephropathy after Elective Endovascular Infrarenal Abdominal Aortic Aneurysm Repair

“…In the patient group with high FIB-4 scores, renal failure developed significantly more often during the follow-up period. At the end of their study, the authors emphasized that the FIB-4 score may be a risk factor not only for liver-related risks but also for renal problems [ 5 ]. In another study, Seko et al included 344 biopsy-proven nonalcoholic fatty liver disease patients.…”

“…In another study that included 3433 patients aged ≥40 years, the authors showed a correlation between atherosclerosis and liver fibrosis scores [ 4 ]. Moreover, in a study conducted on the general population, a high FIB-4 value was shown to be a risk factor for renal insufficiency [ 5 ].…”