Prediction of decreased estimated glomerular filtration rate using liver fibrosis markers: a renal biopsy-based study

Abstract

Non-alcoholic fatty liver disease is the most common chronic liver disease and is associated with chronic kidney disease. The fibrosis-4 index and non-alcoholic fatty liver disease score are widely used as non-invasive diagnostic methods for non-alcoholic fatty liver disease. However, the relationship between these markers and specific renal histopathologies in chronic kidney disease remain unclear. This study included 179 patients aged between 16 and 80 years who underwent renal biopsy. We examined the association between the fibrosis-4 index or non-alcoholic fatty liver disease score and change in estimated glomerular filtration rate 12 months after kidney biopsy for each renal histopathology. Renal histopathologies were determined by renal biopsy. Our results showed that there was a significant negative correlation between the fibrosis-4 index and estimated glomerular filtration rate. In nephrosclerosis, the non-alcoholic fatty liver disease score and estimated glomerular filtration rate tended to have a negative correlation, albeit without significance. In IgA nephropathy, both the fibrosis-4 index and non-alcoholic fatty liver disease score were significantly negatively correlated with estimated glomerular filtration rate. Furthermore, the fibrosis-4 index was not associated with urinary protein-to-creatinine ratio or renal function markers such as urinary b2 microglobulin and urinary N-acetyl-d-glucosamine. Our kidney biopsy-based study showed that the liver fibrosis markers fibrosis-4 index and non-alcoholic fatty liver disease score were negatively correlated with the estimated glomerular filtration rate in nephrosclerosis and IgA nephropathy.

Effect of Sacubitril/Valsartan on Patients Having Heart Failure With Preserved Left Ventricular Ejection Fraction Undergoing Hemodialysis: A Long-term Observational Study

“…Inflammation and oxidative stress play important roles in organ damage progression (18)(19)(20) because they promote fibrosis (21,22). Nuclear factor-kappa-B (NF-ĸB) stimulates cytokine expression via reactive oxygen species and PKCβ.…”

Effect of finerenone on diabetic kidney disease outcomes with estimated glomerular filtration rate below 25 mL/min/1.73 m2

“…Inflammation and oxidative stress play essential roles in DKD initiation, development, and progression [ 27 ]. In addition, they can promote renal fibrosis [ 17 , 28 ]. Finerenone has stronger anti-fibrotic activity than eplerenone.…”

“…UPCR was calculated by dividing the level of protein (mg/dL) in a spot urine test by the creatine level (mg/dL). The eGFR of each patient was calculated using the formula by isotope dilution mass spectrometry (IDMS) traceable 4-variable MDRD (Modification of Diet in Renal Disease) (IDMS-MDRD Study formula) with the 3-variable Japanese equation: 194 × serum creatinine - 1.094 × age - 0.287 × 0.739 (if female) [ [15] , [16] , [17] , [18] ].…”

Chronic kidney disease in nonalcoholic fatty liver disease at primary healthcare centers in Korea

“…Moreover, the liver fibrosis scores (i.e., LS, NFS, and FIB-4, as estimations of hepatic fibrosis) were also higher in those with mild or moderate CKD than in those without CKD in the present study. The kidney biopsy-based study [ 35 ] showed that the liver fibrosis markers FIB-4 and NFS were negatively correlated with the eGFR in nephrosclerosis and IgA nephropathy. This result suggests that it is important to identify individuals with NAFLD early in the course of their disease and provide appropriate treatment and care to prevent negative outcomes.…”