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, N. Chalasani

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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
    Pages (from-to)332-344
    Number of pages13
    JournalAlimentary Pharmacology and Therapeutics
    Volume45
    Issue number2
    DOIs
    Publication statusPublished - 1 Jan 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

    Cite this

    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, N. / 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.
    @article{d5c520bb0d0a426bb8c056d7911377c1,
    title = "Improvement in liver histology due to lifestyle modification is independently associated with improved kidney function in patients with non-alcoholic steatohepatitis",
    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.",
    author = "E. Vilar-Gomez and L. Calzadilla-Bertot and Friedman, {S. L.} and B. Gra-Oramas and L. Gonzalez-Fabian and O. Villa-Jimenez and {Lazo-del Vallin}, S. and M. Diago and Adams, {L. A.} and M. Romero-Gomez and N. Chalasani",
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    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

    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, N.

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

    Research output: Contribution to journalArticle

    TY - JOUR

    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, N.

    PY - 2017/1/1

    Y1 - 2017/1/1

    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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    U2 - 10.1111/apt.13860

    DO - 10.1111/apt.13860

    M3 - Article

    VL - 45

    SP - 332

    EP - 344

    JO - Alimentary pharmacology & therapeutics

    JF - Alimentary pharmacology & therapeutics

    SN - 0269-2813

    IS - 2

    ER -