Progression and new onset of nonalcoholic fatty liver disease in living kidney donors compared to healthy controls

Clin Transplant. 2018 May;32(5):e13240. doi: 10.1111/ctr.13240. Epub 2018 Apr 10.

Abstract

Background: There is growing evidence linking nonalcoholic fatty liver disease (NAFLD) with reduced glomerular filtration rate (GFR). Living kidney donors do not have underlying kidney disease, but have reduced GFR as a result of nephrectomy. Whether kidney donation is associated with a higher risk for development or progression of NAFLD is currently unknown.

Methods: Retrospective evaluation of metabolic parameters and sonographic evidence of NAFLD were performed in 232 living kidney donors and 162 healthy controls.

Results: A total of 25 donors and 44 controls had NAFLD at baseline. During a mean follow-up of 6.8 years, 6 donors (24%) and 17 controls (38.6%) (P = .29) had a remission of NAFLD, related with decreased body mass index (BMI). The progression of NAFLD fibrosis score was similar in both groups. New onset of NAFLD was observed in 14 (6.8%) donors and 13 (11.01%) controls (P = .211), and was related to increased BMI and a higher baseline Fatty Liver Index score. Neither eGFR nor urine albumin excretion in the donors were related to new onset or progression of NAFLD.

Conclusions: Reduced kidney function secondary to kidney donation is not associated with increased incidence or progression of NAFLD.

Keywords: glomerular filtration rate; living kidney donors; metabolic syndrome; nonalcoholic fatty liver disease.

MeSH terms

  • Adult
  • Age of Onset
  • Case-Control Studies
  • Disease Progression
  • Female
  • Follow-Up Studies
  • Glomerular Filtration Rate
  • Humans
  • Kidney Function Tests
  • Kidney Transplantation*
  • Living Donors / statistics & numerical data*
  • Male
  • Middle Aged
  • Nephrectomy / adverse effects*
  • Non-alcoholic Fatty Liver Disease / etiology*
  • Non-alcoholic Fatty Liver Disease / pathology
  • Postoperative Complications / etiology*
  • Postoperative Complications / pathology
  • Prognosis
  • Retrospective Studies
  • Risk Factors