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Liver, Kidney Disease Linked in Type 2 Diabetes

Those with diabetes and non-alcoholic fatty liver disease have higher risk of chronic kidney disease

WEDNESDAY, June 4 (HealthDay News) -- In people with type 2 diabetes, non-alcoholic fatty liver disease is associated with a moderately increased risk of chronic kidney disease, according to research released online April 2 in advance of publication in an upcoming issue of the Journal of the American Society of Nephrology.

Giovanni Targher, M.D., of the University of Verona, Italy, and colleagues analyzed data from 1,760 subjects with type 2 diabetes and near-normal kidney function or better, who were followed for 6.5 years, to assess the development of chronic kidney disease. During this time, 547 subjects developed chronic kidney disease, as defined by overt proteinuria or excessively low glomerular filtration rate.

Having non-alcoholic fatty liver disease was associated with an increased risk of chronic kidney disease (hazard ratio, 1.49) after adjustment for a variety of confounding factors, including body mass index, smoking, diabetes duration and a variety of medications.

"The possible molecular mediators linking non-alcoholic fatty liver disease and chronic kidney disease may include the release of some pathogenic factors from the liver, including elevated advanced glycated end products, increased reactive oxygen species, elevated C-reactive protein, TNF-α, TGF-β1, and other proinflammatory cytokines. Importantly, several studies have shown that these potential mediators of vascular and/or renal injury are remarkably higher in diabetic/obese patients with non-alcoholic fatty liver disease than in those without and are thought to be pathogenic factors for the progression of chronic kidney disease," the authors write.

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