Non-obese non-alcoholic fatty liver disease and the risk of chronic kidney disease: a systematic review and meta-analysis

PeerJ. 2024 Dec 17:12:e18459. doi: 10.7717/peerj.18459. eCollection 2024.

Abstract

Background: Data on risk of developing chronic kidney disease (CKD) between non-obese and obese non-alcoholic fatty liver disease (NAFLD) patients are limited. We aimed to reveal the risk difference of incident CKD between non-obese and obese NAFLD patients.

Methods: We searched PubMed, Embase, and Web of Science databases for studies which reported the incidence of CKD in non-obese and obese NAFLD from inception to 10 March 2024. The primary and secondary outcomes were pooled. Subgroup analysis was used to examine the heterogeneity.

Results: A total of 15 studies were incorporated. The incidence of CKD in non-obese and obese NAFLD were 1,450/38,720 (3.74%) and 3,067/84,154 (3.64%), respectively. Non-obese NAFLD patients had a comparable risk of CKD as obese NAFLD (odds ratio [OR] 0.92, 95% confidence interval [95% CI] [0.72-1.19], I2 = 88%). No differences in estimated glomerular filtration rate and serum creatinine between non-obese and obese NAFLD were found. The mean differences (MD) and 95% CI were 0.01 [-0.02 to 0.04] and 0.50 [-0.90 to 1.90], respectively. In subgroup analyses, non-obese NAFLD had higher eGFR when diagnosed with ultrasound (MD 1.45, 95% CI [0.11-2.79], I2 = 21%). Non-obese NAFLD had higher creatinine in non-Asian (MD 0.06, 95% CI [0.01-0.11], I2 = 55%) and when taking BMI > 30 as the criterion for obesity (MD 0.06, 95% CI [0.00-0.12], I2 = 76%). The occurrence of CKD did not differ when non-obese NAFLD were categorized into overweight and normal-weight types.

Conclusions: Non-obese NAFLD patients experienced the same risk of CKD compared to obese NAFLD.

Keywords: CKD; Creatinine; NAFLD; Non-obese; eGFR.

Publication types

  • Systematic Review
  • Meta-Analysis

MeSH terms

  • Glomerular Filtration Rate
  • Humans
  • Incidence
  • Non-alcoholic Fatty Liver Disease* / complications
  • Non-alcoholic Fatty Liver Disease* / epidemiology
  • Obesity* / complications
  • Obesity* / epidemiology
  • Renal Insufficiency, Chronic* / epidemiology
  • Renal Insufficiency, Chronic* / etiology
  • Risk Factors

Grants and funding

This work was supported by the National Key Research and Development Program of China (grant numbers 2022YFC2304800), and National Natural Science Foundation of China (grant numbers 82172254). The APC was funded by the Science and Technological Supports Project of Sichuan Province, China; No. 2024YFFK0214. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.