الفهرس 
Chapter 1: Non-alcoholic fatty liver disease (NAFLDOnly 14 pages are availabe for public view
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Abstract
Introduction:
Nonalcoholic fatty liver disease (NAFLD) is a spectrum of disorders ranging from hepatic steatosis to nonalcoholic steatohepatitis (NASH), NASH related cirrhosis and hepatocellular carcinoma (HCC). chronic Kidney Disease (CKD) is a significant public health problem worldwide because of the poor outcomes experienced by patients and high associated costs. Nonalcoholic fatty liver disease (NAFLD) and chronic kidney disease (CKD) share common features. Both are associated with visceral obesity, type 2 diabetes mellitus, metabolic syndrome, and insulin resistance. However, the relationship between NAFLD and CKD is poorly understood. There is sparse data on the prevalence CKD in Egyptian patients with (NAFLD).
Aim of the work:
This cross-sectional study aimed to estimate the prevalence of CKD in individuals with and without NAFLD and to assess the risk factors of CKD in NAFLD individuals.
Patients and methods:
This study was conducted on 430 patients from the Internal Medicine Department, Menoufia University Hospitals, including 215 patients with NAFLD, and 215 patients without NAFLD. NAFLD was diagnosed by abdominal ultrasonography. The liver fibrosis was assessed by NAFLD fibrosis score (NFS) and fibrosis-4 index (FIB4). CKD was defined as an estimated glomerular filtration rate (eGFR) < 60 ml/min/1.73 m2 and/or abnormal albuminuria (urinary albuminto-creatinine ratio ⩾ 30 mg/gm). The logistic regression analysis was performed to examine the association between NAFLD and risk of CKD.
Results:
The prevalence of CKD and was higher in individuals with NAFLD than in those without NAFLD (38.1 % vs 7.4 %, p < 0.001). The patients’ platelets, creatinine, urea, ACR, AST, ALT, total cholesterol, triglycerides, LDL, FPG, and LDH were significantly higher among the NAFLD group, p<0.05. While the mean values of the patients’ eGFR, albumin, prothrombin activity, and HDL were significantly higher among the non-NAFLD group, p<0.05. Abnormal albuminuria was significantly more present in the NAFLD than nonNAFLD group (24.7% vs 7%). The mean NFS score of the CKD patients were significantly higher than the non-CKD patients. Logistic regression analysis demonstrated that both NAFLD and CKD were risk factors of each other. The presence of hypertension, and the high levels of BMI and waist circumference were the other independent risk factors of NAFLD. While the presence of DM, and the high level of BMI were the other significant risk factors of CKD in the NAFLD group.
Conclusion:
The presence and severity of NAFLD are associated with an increased risk and severity of CKD.