Evidence mapPaperPMID 32988952Full record

SynthesisBMJ open2020

Systematic review of the impact of non-alcoholic fatty liver disease on mortality and adverse clinical outcomes for individuals with chronic kidney disease.

Theresa Hydes, Ryan Buchanan, Oliver J Kennedy, Simon Fraser, Julie Parkes, Paul Roderick

Open access · goldAbstract readSystematic Review
In one paragraph

Synthesis in BMJ open, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
9citing papers in PubMed, 2 pooled it
0.9field-weighted citation impact, top 24% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

9 citing papers in PubMed, 2 syntheses or guidelines pooled it, 10 citations in OpenAlex.

  1. Pooled it
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors at 1 institution in 1 country.

Theresa HydesSchool of Primary Care and Population Sciences, Faculty of Medicine, University of Southampton, Southampton, UK therasa@doctors.org.uk.ORCID 0000-0002-7768-6886
Ryan BuchananSchool of Primary Care and Population Sciences, Faculty of Medicine, University of Southampton, Southampton, UK.
Oliver J KennedySchool of Primary Care and Population Sciences, Faculty of Medicine, University of Southampton, Southampton, UK.
Simon FraserSchool of Primary Care and Population Sciences, Faculty of Medicine, University of Southampton, Southampton, UK.ORCID 0000-0002-4172-4406
Julie ParkesSchool of Primary Care and Population Sciences, Faculty of Medicine, University of Southampton, Southampton, UK.
Paul RoderickSchool of Primary Care and Population Sciences, Faculty of Medicine, University of Southampton, Southampton, UK.
University of Southampton · GB

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectivesTo investigate if non-alcoholic fatty liver disease (NAFLD) impacts mortality and adverse outcomes for individuals with chronic kidney disease (CKD).

designSystematic review. DATA SOURCES: PubMed, EMBASE and Web of Science were searched up to 1 February 2020 with no restriction on the earliest date. ELIGIBILITY CRITERIA FOR SELECTING STUDIES: Observational cohort studies that reported either the risk of all-cause mortality, incidence of non-fatal cardiovascular events (CVE) or progression of kidney disease among adults with established CKD who have NAFLD compared with those without. DATA EXTRACTION AND SYNTHESIS: Two reviewers extracted data and assessed bias independently.

resultsOf 2604 records identified, 3 studies were included (UK (n=852), South Korea (n=1525) and USA (n=1413)). All were judged to have a low or moderate risk of bias. Data were insufficient for meta-analysis. Two studies examined the influence of NAFLD on all-cause mortality. One reported a significant positive association for NAFLD with all-cause mortality for individuals with CKD (p<0.05) (cardiovascular-related mortality p=ns), which was lost following adjustment for metabolic risk factors; the second reported no effect in adjusted and unadjusted models. The latter was the only study to report outcomes for non-fatal CVEs and observed NAFLD to be an independent risk factor for this (propensity-matched HR=2.00, p=0.02). Two studies examined CKD progression; in one adjusted rate of percentage decline in estimated glomerular filtration rate per year was found to be increased in those with NAFLD (p=0.002), whereas the other found no significant difference.

conclusionsFew studies have examined the influence of NAFLD on prognosis and major adverse clinical outcomes within the CKD population. The studies identified were diverse in design and results were conflicting. This should be a focus for future research as both conditions continue to rise in prevalence and have end-stage events associated with significant health and economic costs. PROSPERO REGISTRATION NUMBER: CRD42020166508.

Indexed as

Non-alcoholic Fatty Liver DiseaseRenal Insufficiency, ChronicAdultGlomerular Filtration RateHumansRepublic of KoreaRisk Factorschronic renal failureend stage renal failurehepatologymyocardial infarction

Identifiers

PMID32988952
PMCPMC7523199
OpenAlexW3088101551

What Socratic holds

Textmetadata
LicenceCC BY-NC
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.