E0492 - Nephrotic Syndrome Is Associated With a Higher Risk of NAFLD: A Population-Based Study

Somtochukwu Onwuzo, MD¹, Asif Hitawala, MD², Antoine Boustany, MD, MPH¹, Ashraf Almomani, MD¹, Prabhat Kumar, MD¹, Eduard Krishtopaytis, MD^1
1Cleveland Clinic Foundation, Cleveland, OH; ²National Institutes of Health, Bethesda, MD

Introduction: Non-alcoholic fatty liver disease (NAFLD) is fast emerging as a global health prime concern with a prevalence of 25% with wide geographical variation worldwide with increased prevalence in patients with obesity, and metabolic syndrome, partly due to similar mechanisms of injury. In the later stages of NAFLD, pronounced liver inflammation leading to cirrhosis and subsequent protein loss is seen. A similar and often even more pronounced loss is seen in patients with nephrotic syndrome. Our aim is to identify the prevalence of NAFLD in patients with nephrotic syndrome.

Methods: A large multi-center database (Explorys Inc., Cleveland, OH, USA) of aggregated electronic health records of 26 different healthcare systems with a total of 360 hospitals and more than 70 million patients across the United States was utilized for this study. A cohort of patients with a SNOMED-CT diagnosis of “Non-Alcoholic fatty liver disease” between 1999-2022 was identified. We excluded all patients with a history of chronic kidney disease. Statistical Package for Social Sciences (SPSS version 25, IBM Corp) was used for statistical analysis, and for all analyses, a 2-sided p-value of < 0.05 was considered statistically significant. Multivariate analysis was performed to adjust for multiple factors including age, sex, race, nephrotic syndrome, type II diabetes mellitus, hypothyroidism, hyperlipidemia, obesity, and metabolic syndrome

Results: Among the 78,608,370 individuals screened in this database, there were a total of 49500 with NAFLD with a prevalence rate of 62 per 100,000 and a total of 17,360 with Nephrotic syndrome with a prevalence rate of 22 per 100,000. The baseline characteristics of patients with NAFLD and Nephrotic syndrome is shown in Tables 1. In a multivariate analysis, the odds of having NAFLD amongst patients with nephrotic syndrome were increased at 5.69 (95% Cl 4.94-6.52). The odds of having NAFLD patients were also increased in patients that have type 2 diabetes mellitus OR 3.87(95% Cl 3.79-3.95), hypothyroidism OR 1.62 (95% Cl 1.58-1.65), obesity OR 5.54 (95% Cl 5.42-5.65), Hyperlipidemia OR 3.49 (95% Cl 3.41-3.58), and metabolic syndrome OR 3.35 (95% Cl 3.23-3.47) as well (Table 2).

Discussion: This study highlights the increased risk of developing NAFLD in patients with nephrotic syndrome independently of other risk factors. Hence, routine surveillance for liver disease is recommended for patients with nephrotic syndrome.




Disclosures:


Somtochukwu Onwuzo, MD¹, Asif Hitawala, MD², Antoine Boustany, MD, MPH¹, Ashraf Almomani, MD¹, Prabhat Kumar, MD¹, Eduard Krishtopaytis, MD¹. E0492 - Nephrotic Syndrome Is Associated With a Higher Risk of NAFLD: A Population-Based Study, ACG 2022 Annual Scientific Meeting Abstracts. Charlotte, NC: American College of Gastroenterology.