2008 JASN IMPACT FACTOR 7.505	HOME   AUTHOR INFO   EDITORIAL BOARD   SUBSCRIBE   FEEDBACK   ALERTS   HELP
advanced	CURRENT ISSUE	ARCHIVES	JASN Express	ONLINE SUBMISSION

This Article Full Text Full Text (PDF) All Versions of this Article: ASN.2007101155v1 19/8/1564    most recent Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via Google Scholar Google Scholar Articles by Targher, G. Articles by Muggeo, M. Search for Related Content PubMed PubMed Citation Articles by Targher, G. Articles by Muggeo, M. Related Collections Related Article

Increased Risk of CKD among Type 2 Diabetics with Nonalcoholic Fatty Liver Disease

Giovanni Targher^*,, Michel Chonchol, Lorenzo Bertolini, Stefano Rodella, Luciano Zenari, Giuseppe Lippi^||, Massimo Franchini^¶, Giacomo Zoppini^* and Michele Muggeo^*

^* Section of Endocrinology, Department of Biomedical and Surgical Sciences, and ^|| Section of Clinical Chemistry, Department of Biomedical and Morphological Sciences, University of Verona, and ^¶ Service of Immuno-hematology and Transfusion, Civil Hospital, Verona, Department of Internal Medicine and Diabetes Unit and Department of Radiology, "Sacro Cuore" Hospital, Negrar, Italy; and Division of Renal Diseases and Hypertension, University of Colorado Health Sciences Center, Denver, Colorado

Correspondence: Dr. Giovanni Targher, Section of Endocrinology, Department of Biomedical and Surgical Sciences, University of Verona, Ospedale Civile Maggiore, Piazzale Stefani, 1, 37126 Verona, Italy. Phone: 0039-045-8123748; Fax: 0039-045-917374; E-mail: giovanni.targher{at}univr.it

Received for publication October 30, 2007. Accepted for publication February 11, 2008.

It is unknown whether chronic kidney disease (CKD) is associated with nonalcoholic fatty liver disease among patients with type 2 diabetes. We followed 1760 outpatients with type 2 diabetes and normal or near-normal kidney function and without overt proteinuria for 6.5 yr for the occurrence of CKD (defined as overt proteinuria and/or estimated GFR <60 ml/min per 1.73 m²). During follow-up, 547 participants developed incident CKD. Nonalcoholic fatty liver disease, diagnosed by liver ultrasound and exclusion of other common causes of chronic liver disease, was associated with a moderately increased risk for CKD (hazard ratio 1.69; 95% confidence interval 1.3 to 2.6; P < 0.001). Adjustments for gender, age, body mass index, waist circumference, BP, smoking, diabetes duration, glycosylated hemoglobin, lipids, baseline estimated GFR, microalbuminuria, and medications (hypoglycemic, lipid-lowering, antihypertensive, or antiplatelet drugs) did not appreciably attenuate this association (hazard ratio 1.49; 95% confidence interval 1.1 to 2.2; P < 0.01). In conclusion, our findings suggest that nonalcoholic fatty liver disease is associated with an increased incidence of CKD in individuals with type 2 diabetes, independent of numerous baseline confounding factors.

Related Article

This Month's Highlights
J. Am. Soc. Nephrol. 2008 19: A6. [Full Text] [PDF]

Copyright © 2009 by the American Society of Nephrology. Online ISSN: 1533-3450 Print ISSN: 1046-6673