Yodoshi et al conducted a study to establish the prevalence of renal impairment in a cohort of youths with histologically confirmed nonalcoholic fatty liver disease (NAFLD). The investigators also aimed to ascertain its association with liver disease severity.

In a pediatric cohort with biopsy-confirmed NAFLD, investigators collected clinical, laboratory, and histology data retrospectively at a tertiary care center from 2010 to 2017. Histological NAFLD severity was scored and glomerular filtration rate (GFR) was calculated and categorized into low (<90 mL/min/1.73 m2), normal (90-136 mL/min/1.73 m2), or high (>136 mL/min/1.73 m2) categories. 

There were 179 patients in the study (median age 14 years). About a third of the patients had abnormal renal function, with 36 (20%) having glomerular hyperfiltration and 26 (15%) having low GFR.

Multivariable logistic regression revealed that in comparison with normal GFR, hyperfiltration had an independent association with greater NAFLD activity score, after adjustment for age, sex, ethnicity, obesity severity, presence of type 2 diabetes mellitus, as well as medications.

Renal impairment was found to be highly prevalent in this cohort with histologically confirmed NAFLD, and was associated with liver disease severity, independent of obesity severity. Investigators thus recommend screening patients with confirmed NAFLD for renal complication.

Source: Yodoshi T, Arce-Clachar AC, Sun Q, et al. Glomerular Hyperfiltration Is Associated with Liver Disease Severity in Children with Nonalcoholic Fatty Liver Disease. J Pediatr. 2020 May 4. pii: S0022-3476(20)30392-9.