Improvement in liver histology due to lifestyle modification is independently associated with improved kidney function in patients with non-alcoholic steatohepatitis

E. Vilar-Gomez, L. Calzadilla-Bertot, S. L. Friedman, B. Gra-Oramas, L. Gonzalez-Fabian, O. Villa-Jimenez, S. Lazo-del Vallin, M. Diago, L. A. Adams, M. Romero-Gomez, Naga Chalasani

Research output: Contribution to journalArticle

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Abstract

Background: Several recent studies have shown a strong association between non-alcoholic steatohepatitis (NASH) and chronic kidney disease. Aim: To examine the relationship between changes in liver histology and renal function in patients with NASH. Methods: The present analysis represents a post hoc analysis of a recently published trial that included 261 patients with NASH who were treated with lifestyle modifications during 52 weeks. Kidney function was evaluated through Chronic Kidney Disease Epidemiology Collaboration estimated glomerular filtration rates (eGFR, mL/min/1.73 m2) overtime. We explored correlations between the kidney function and improvement in histological outcomes at 52 weeks. Results: Interestingly, a one-stage reduction in fibrosis (r = 0.20, P < 0.01) and resolution of NASH (r = 0.17, P < 0.01) were significantly correlated with an improvement in the kidney function. The eGFR values significantly increased in patients with fibrosis improvement (+7.6 ± 6.5 mL/min/1.73 m2), compared to those without fibrosis improvement (−1.98 ± 6.4 mL/min/1.73 m2) (P < 0.01) at end of treatment (EOT). Likewise, NASH resolution was associated with an increase in eGFR compared with patients without NASH resolution (2.32 ± 7.8 mL/min/1.73 m2 vs. −1.04 ± 5.9 mL/min/1.73 m2, P = 0.04) at EOT. After controlling for the confounders, the association between fibrosis improvement, NASH resolution and eGFR change remained significant (P < 0.05 for both). Conclusions: Improvement in liver histology due to lifestyle modification is independently associated with improved kidney function in NASH. As new drugs for NASH emerge, studies should address whether improvement in histology in response to pharmacotherapies yield the same improvement in kidney function as weight loss.

Original languageEnglish (US)
Pages (from-to)332-344
Number of pages13
JournalAlimentary Pharmacology and Therapeutics
Volume45
Issue number2
DOIs
StatePublished - Jan 1 2017

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Fatty Liver
Life Style
Histology
Kidney
Liver
Fibrosis
Chronic Renal Insufficiency
Glomerular Filtration Rate
Weight Loss
Epidemiology
Drug Therapy
Therapeutics

ASJC Scopus subject areas

  • Pharmacology (medical)

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Improvement in liver histology due to lifestyle modification is independently associated with improved kidney function in patients with non-alcoholic steatohepatitis. / Vilar-Gomez, E.; Calzadilla-Bertot, L.; Friedman, S. L.; Gra-Oramas, B.; Gonzalez-Fabian, L.; Villa-Jimenez, O.; Lazo-del Vallin, S.; Diago, M.; Adams, L. A.; Romero-Gomez, M.; Chalasani, Naga.

In: Alimentary Pharmacology and Therapeutics, Vol. 45, No. 2, 01.01.2017, p. 332-344.

Research output: Contribution to journalArticle

Vilar-Gomez, E, Calzadilla-Bertot, L, Friedman, SL, Gra-Oramas, B, Gonzalez-Fabian, L, Villa-Jimenez, O, Lazo-del Vallin, S, Diago, M, Adams, LA, Romero-Gomez, M & Chalasani, N 2017, 'Improvement in liver histology due to lifestyle modification is independently associated with improved kidney function in patients with non-alcoholic steatohepatitis', Alimentary Pharmacology and Therapeutics, vol. 45, no. 2, pp. 332-344. https://doi.org/10.1111/apt.13860
Vilar-Gomez, E. ; Calzadilla-Bertot, L. ; Friedman, S. L. ; Gra-Oramas, B. ; Gonzalez-Fabian, L. ; Villa-Jimenez, O. ; Lazo-del Vallin, S. ; Diago, M. ; Adams, L. A. ; Romero-Gomez, M. ; Chalasani, Naga. / Improvement in liver histology due to lifestyle modification is independently associated with improved kidney function in patients with non-alcoholic steatohepatitis. In: Alimentary Pharmacology and Therapeutics. 2017 ; Vol. 45, No. 2. pp. 332-344.
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abstract = "Background: Several recent studies have shown a strong association between non-alcoholic steatohepatitis (NASH) and chronic kidney disease. Aim: To examine the relationship between changes in liver histology and renal function in patients with NASH. Methods: The present analysis represents a post hoc analysis of a recently published trial that included 261 patients with NASH who were treated with lifestyle modifications during 52 weeks. Kidney function was evaluated through Chronic Kidney Disease Epidemiology Collaboration estimated glomerular filtration rates (eGFR, mL/min/1.73 m2) overtime. We explored correlations between the kidney function and improvement in histological outcomes at 52 weeks. Results: Interestingly, a one-stage reduction in fibrosis (r = 0.20, P < 0.01) and resolution of NASH (r = 0.17, P < 0.01) were significantly correlated with an improvement in the kidney function. The eGFR values significantly increased in patients with fibrosis improvement (+7.6 ± 6.5 mL/min/1.73 m2), compared to those without fibrosis improvement (−1.98 ± 6.4 mL/min/1.73 m2) (P < 0.01) at end of treatment (EOT). Likewise, NASH resolution was associated with an increase in eGFR compared with patients without NASH resolution (2.32 ± 7.8 mL/min/1.73 m2 vs. −1.04 ± 5.9 mL/min/1.73 m2, P = 0.04) at EOT. After controlling for the confounders, the association between fibrosis improvement, NASH resolution and eGFR change remained significant (P < 0.05 for both). Conclusions: Improvement in liver histology due to lifestyle modification is independently associated with improved kidney function in NASH. As new drugs for NASH emerge, studies should address whether improvement in histology in response to pharmacotherapies yield the same improvement in kidney function as weight loss.",
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T1 - Improvement in liver histology due to lifestyle modification is independently associated with improved kidney function in patients with non-alcoholic steatohepatitis

AU - Vilar-Gomez, E.

AU - Calzadilla-Bertot, L.

AU - Friedman, S. L.

AU - Gra-Oramas, B.

AU - Gonzalez-Fabian, L.

AU - Villa-Jimenez, O.

AU - Lazo-del Vallin, S.

AU - Diago, M.

AU - Adams, L. A.

AU - Romero-Gomez, M.

AU - Chalasani, Naga

PY - 2017/1/1

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N2 - Background: Several recent studies have shown a strong association between non-alcoholic steatohepatitis (NASH) and chronic kidney disease. Aim: To examine the relationship between changes in liver histology and renal function in patients with NASH. Methods: The present analysis represents a post hoc analysis of a recently published trial that included 261 patients with NASH who were treated with lifestyle modifications during 52 weeks. Kidney function was evaluated through Chronic Kidney Disease Epidemiology Collaboration estimated glomerular filtration rates (eGFR, mL/min/1.73 m2) overtime. We explored correlations between the kidney function and improvement in histological outcomes at 52 weeks. Results: Interestingly, a one-stage reduction in fibrosis (r = 0.20, P < 0.01) and resolution of NASH (r = 0.17, P < 0.01) were significantly correlated with an improvement in the kidney function. The eGFR values significantly increased in patients with fibrosis improvement (+7.6 ± 6.5 mL/min/1.73 m2), compared to those without fibrosis improvement (−1.98 ± 6.4 mL/min/1.73 m2) (P < 0.01) at end of treatment (EOT). Likewise, NASH resolution was associated with an increase in eGFR compared with patients without NASH resolution (2.32 ± 7.8 mL/min/1.73 m2 vs. −1.04 ± 5.9 mL/min/1.73 m2, P = 0.04) at EOT. After controlling for the confounders, the association between fibrosis improvement, NASH resolution and eGFR change remained significant (P < 0.05 for both). Conclusions: Improvement in liver histology due to lifestyle modification is independently associated with improved kidney function in NASH. As new drugs for NASH emerge, studies should address whether improvement in histology in response to pharmacotherapies yield the same improvement in kidney function as weight loss.

AB - Background: Several recent studies have shown a strong association between non-alcoholic steatohepatitis (NASH) and chronic kidney disease. Aim: To examine the relationship between changes in liver histology and renal function in patients with NASH. Methods: The present analysis represents a post hoc analysis of a recently published trial that included 261 patients with NASH who were treated with lifestyle modifications during 52 weeks. Kidney function was evaluated through Chronic Kidney Disease Epidemiology Collaboration estimated glomerular filtration rates (eGFR, mL/min/1.73 m2) overtime. We explored correlations between the kidney function and improvement in histological outcomes at 52 weeks. Results: Interestingly, a one-stage reduction in fibrosis (r = 0.20, P < 0.01) and resolution of NASH (r = 0.17, P < 0.01) were significantly correlated with an improvement in the kidney function. The eGFR values significantly increased in patients with fibrosis improvement (+7.6 ± 6.5 mL/min/1.73 m2), compared to those without fibrosis improvement (−1.98 ± 6.4 mL/min/1.73 m2) (P < 0.01) at end of treatment (EOT). Likewise, NASH resolution was associated with an increase in eGFR compared with patients without NASH resolution (2.32 ± 7.8 mL/min/1.73 m2 vs. −1.04 ± 5.9 mL/min/1.73 m2, P = 0.04) at EOT. After controlling for the confounders, the association between fibrosis improvement, NASH resolution and eGFR change remained significant (P < 0.05 for both). Conclusions: Improvement in liver histology due to lifestyle modification is independently associated with improved kidney function in NASH. As new drugs for NASH emerge, studies should address whether improvement in histology in response to pharmacotherapies yield the same improvement in kidney function as weight loss.

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