Interrelationships between Non-Alcoholic Fatty Liver Disease and Chronic Kidney Disease
Summary
Non-alcoholic fatty liver disease (NAFLD) and chronic kidney disease (CKD) frequently coexist, reflecting shared cardiometabolic risk factors and overlapping pathophysiological mechanisms. NAFLD, defined by excessive hepatic lipid accumulation, may progress to non-alcoholic steatohepatitis (NASH), fibrosis and cirrhosis, while CKD is marked by a persistent decline in glomerular function. Insulin resistance, visceral adiposity, dyslipidaemia and chronic low-grade inflammation underpin both conditions, with adipokine imbalances and activation of the renin–angiotensin–aldosterone system amplifying tissue injury. Hepatic steatosis can promote systemic release of proinflammatory and profibrotic mediators, contributing to glomerular endothelial damage and tubular fibrosis. Conversely, renal impairment may exacerbate oxidative stress and perturb lipid handling in the liver. Epidemiological evidence demonstrates that NAFLD independently increases the risk of incident CKD and accelerates renal function decline, particularly when liver fibrosis is advanced. Recognition of this bidirectional interplay has prompted calls for integrated screening strategies and therapeutic approaches that target common molecular pathways to mitigate progression of both liver and kidney disease.
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Interrelationships between Non-Alcoholic Fatty Liver Disease and Chronic Kidney Disease publication trend
The graph below shows the total number of articles in interrelationships between non-alcoholic fatty liver disease and chronic kidney disease across all publications each year (not limited to Nature Index journals).
Technical terms
Hepatic steatosis: Excessive accumulation of triglycerides within hepatocytes, marking the earliest stage of NAFLD.
Non-alcoholic steatohepatitis (NASH): An inflammatory form of NAFLD characterised by hepatocyte injury, ballooning and varying degrees of fibrosis.
Glomerular filtration rate (GFR): An estimate of the volume of plasma filtered by the renal glomeruli per minute, used to assess renal function.
Albuminuria: Presence of albumin in the urine, indicating glomerular barrier disruption and predictive of CKD progression.
Transforming growth factor beta (TGF-β): A cytokine that promotes extracellular matrix deposition and fibrosis in both liver and kidney tissues.
References
- Increased risk for microvascular outcomes in NAFLD—A nationwide, population‐based cohort study. Journal of Internal Medicine (2023).
- Genetic deletion of phosphodiesterase 4D in the liver improves kidney damage in high-fat fed mice: liver-kidney crosstalk. Cell Death & Disease (2023).
- The impact of non-alcoholic fatty liver disease and liver fibrosis on adverse clinical outcomes and mortality in patients with chronic kidney disease: a prospective cohort study using the UK Biobank. BMC Medicine (2023).
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