Evidence map›Paper›PMID 37198624›Full record

ArticleBMC medicine2023

The impact of non-alcoholic fatty liver disease and liver fibrosis on adverse clinical outcomes and mortality in patients with chronic kidney disease: a prospective cohort study using the UK Biobank.

Theresa J Hydes, Oliver J Kennedy, Ryan Buchanan, Daniel J Cuthbertson, Julie Parkes, Simon D S Fraser, Paul Roderick

Open access · goldAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in BMC medicine, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 29 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
29citing papers in PubMed, 2 pooled it
9.0field-weighted citation impact, top 1% 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

29 citing papers in PubMed, 2 syntheses or guidelines pooled it, 42 citations in OpenAlex.

  1. Pooled it
  2. Pooled it
  3. Article
  4. Article
  5. Review
  6. Article
  7. Review
  8. Article
  9. Review
  10. Article
  11. Article
  12. Article
  13. Article
  14. Article
  15. Review
  16. Article
  17. Review
  18. Review
  19. Article
  20. Article
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

7 authors at 3 institutions in 1 country.

Theresa J Hydes *Department of Cardiovascular and Metabolic Medicine, 3Rd Floor Clinical Sciences Centre, Institute of Life Course and Medical Sciences, Liverpool University Hospitals NHS Foundation Trust, University of Liverpool, Longmoor Lane, Liverpool, L9 7AL, UK. theresa.hydes@liverpool.ac.uk.ORCID 0000-0002-7768-6886
Oliver J Kennedy *School of Primary Care, Population Sciences and Medical Education, University of Southampton, Southampton, SO17 1BJ, UK.
Ryan BuchananSchool of Primary Care, Population Sciences and Medical Education, University of Southampton, Southampton, SO17 1BJ, UK.
Daniel J CuthbertsonDepartment of Cardiovascular and Metabolic Medicine, 3Rd Floor Clinical Sciences Centre, Institute of Life Course and Medical Sciences, Liverpool University Hospitals NHS Foundation Trust, University of Liverpool, Longmoor Lane, Liverpool, L9 7AL, UK.
Julie ParkesSchool of Primary Care, Population Sciences and Medical Education, University of Southampton, Southampton, SO17 1BJ, UK.
Simon D S FraserSchool of Primary Care, Population Sciences and Medical Education, University of Southampton, Southampton, SO17 1BJ, UK.
Paul RoderickSchool of Primary Care, Population Sciences and Medical Education, University of Southampton, Southampton, SO17 1BJ, UK.
University of Southampton · GBUniversity of Liverpool · GBSouthampton General Hospital · GB

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundChronic kidney disease (CKD) and non-alcoholic fatty liver disease (NAFLD) frequently co-exist. We assess the impact of having NAFLD on adverse clinical outcomes and all-cause mortality for people with CKD.

methodsA total of 18,073 UK Biobank participants identified to have CKD (eGFR < 60 ml/min/1.73 m

results56.2% of individuals with CKD had NAFLD at baseline, and 3.0% and 7.7% had NAFLD fibrosis according to a FIB-4 > 2.67 and NFS ≥ 0.676, respectively. The median follow-up was 13 years. In univariate analysis, NAFLD was associated with an increased risk of CVE (HR 1.49 [1.38-1.60]), all-cause mortality (HR 1.22 [1.14-1.31]) and ESRD (HR 1.26 [1.02-1.54]). Following multivariable adjustment, NAFLD remained an independent risk factor for CVE overall (HR 1.20 [1.11-1.30], p < 0.0001), but not ACM or ESRD. In univariate analysis, elevated NFS and FIB-4 scores were associated with increased risk of CVE (HR 2.42 [2.09-2.80] and 1.64 [1.30-2.08]) and all-cause mortality (HR 2.82 [2.48-3.21] and 1.82 [1.47-2.24]); the NFS score was also associated with ESRD (HR 5.15 [3.52-7.52]). Following full adjustment, the NFS remained associated with an increased incidence of CVE (HR 1.19 [1.01-1.40]) and all-cause mortality (HR 1.31 [1.13-1.52]).

conclusionsIn people with CKD, NAFLD is associated with an increased risk of CVE, and the NAFLD fibrosis score is associated with an elevated risk of CVE and worse survival.

Indexed as

Kidney Failure, ChronicNon-alcoholic Fatty Liver DiseaseRenal Insufficiency, ChronicBiological Specimen BanksHumansLiver CirrhosisProspective StudiesSeverity of Illness IndexUnited KingdomCardiovascular diseaseChronic kidney diseaseMulti-morbidityNon-alcoholic fatty liver disease

Identifiers

PMID37198624
PMCPMC10193672
OpenAlexW4376958833

What Socratic holds

Textmetadata
LicenceCC BY
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.