Onwuzo SS, Hitawala AA, Boustany A, Kumar P, Almomani A, Onwuzo C, Monteiro JM, Asaad I. Prevalence of non-alcoholic fatty liver disease in patients with nephrotic syndrome: A population-based study. World J Hepatol 2023; 15(2): 265-273 [PMID: 36926242 DOI: 10.4254/wjh.v15.i2.265]
Corresponding Author of This Article
Somtochukwu Stephen Onwuzo, MD, Doctor, Internal Medicine, Cleveland Clinic Foundation, 18101 Lorain Road, Cleveland, OH 44111, United States. onwuzos@ccf.org
Research Domain of This Article
Gastroenterology & Hepatology
Article-Type of This Article
Retrospective Cohort Study
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Hepatol. Feb 27, 2023; 15(2): 265-273 Published online Feb 27, 2023. doi: 10.4254/wjh.v15.i2.265
Prevalence of non-alcoholic fatty liver disease in patients with nephrotic syndrome: A population-based study
Somtochukwu Stephen Onwuzo, Asif Ali Hitawala, Antoine Boustany, Prabhat Kumar, Ashraf Almomani, Chidera Onwuzo, Jessy Mascarenhas Monteiro, Imad Asaad
Somtochukwu Stephen Onwuzo, Asif Ali Hitawala, Antoine Boustany, Prabhat Kumar, Internal Medicine, Cleveland Clinic Foundation, Cleveland, OH 44111, United States
Ashraf Almomani, Digestive Disease and Hepatology, Cleveland Clinic Foundation Florida, Weston, FI 33331, United States
Chidera Onwuzo, Department of Medicine & Surgery, General Hospital Lagos Island, Lagos Island 101223, Lagos, Nigeria
Jessy Mascarenhas Monteiro, Department of Medicine, Ross University School of Medicine, Bridgetown B11093, St Michael, Barbados
Imad Asaad, Digestive Disease and Hepatology, Cleveland Clinic Foundation, Cleveland, OH 44111, United States
Author contributions: Onwuzo S designed the research study; Hitawala A and Boustany A performed the biostatistical analysis; Boustany A and Kumar P carried out the data collection; Onwuzo S, Hitawala A, Onwuzo C, Almomani A, Monteiro J, and Asaad I contributed to the manuscript writing, editing and scientific review; All authors have read and agree to the submitted version of the manuscript.
Institutional review board statement: Our cohort’s data were obtained using a validated, multicentered and daily-updated database called Explorys (Explorys Inc, Cleveland, OH, United States). Explorys does not record individual patient data such as name, laboratory or imaging results. Patient’s informed consent and approval of Institutional Review Board are not required since Explorys is a Health Insurance Portability and Accountability Act (HIPAA)-compliant platform.
Informed consent statement: Consent was not obtained but the presented data are anonymized without any risk of identification.
Conflict-of-interest statement: There are no conflicts of interest to report.
Data sharing statement: Technical appendix, statistical code, and dataset available from the corresponding author at onwuzos@ccf.org. Consent was not obtained but the presented data are anonymized without any risk of identification.
STROBE statement: The authors have read the STROBE Statement—checklist of items, and the manuscript was prepared and revised according to the STROBE Statement—checklist of items.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Somtochukwu Stephen Onwuzo, MD, Doctor, Internal Medicine, Cleveland Clinic Foundation, 18101 Lorain Road, Cleveland, OH 44111, United States. onwuzos@ccf.org
Received: December 6, 2022 Peer-review started: December 6, 2022 First decision: January 11, 2023 Revised: January 21, 2023 Accepted: February 8, 2023 Article in press: February 8, 2023 Published online: February 27, 2023 Processing time: 79 Days and 23.7 Hours
Core Tip
Core Tip: We conducted a population-based study to investigate the prevalence of non-alcoholic fatty liver disease (NAFLD) in patients with Nephrotic syndrome. We screened over 78 million individuals in a nationwide multicenter database. We performed a comprehensive multivariate analysis accounting for multiple cofounding factors including age ≥ 65 years, gender, Caucasian race, obesity, diabetes mellitus type 2, metabolic syndrome, dyslipidemia, chronic kidney disease and hypothyroidism. We found that patients with nephrotic syndrome had a higher prevalence of NAFLD. However, we could not account for certain confounders such as elevated uric acid levels, hormonal therapy, chemotherapy for tumors, and certain drugs such as corticosteroids, which are known to be risk factors for NAFLD. Further studies are required to confirm these findings and assess the utility of surveillance strategies for NAFLD in patients with nephrotic syndrome.
