Title:The Co-Existence of NASH and Chronic Kidney Disease Boosts Cardiovascular Risk: Are there any Common Therapeutic Options?
Volume: 16
Issue: 3
Author(s): Marianna Papademetriou, Vasilios G. Athyros, Eleni Geladari, Michael Doumas, Costas Tsioufis and Vasilios Papademetriou*
Affiliation:
- VAMC and Georgetown University, Washington, DC,United States
Keywords:
Non-alcoholic fatty liver disease, non-alcoholic steatohepatitis, chronic kidney disease, type 2 diabetes, cardiovascular
disease, statins, ACE-I, ARBs, SGLT2i, GLP1 RA.
Abstract: Non-alcoholic fatty liver disease (NAFLD) is becoming the most common chronic liver disease.
NAFLD may evolve to non-alcoholic steatohepatitis (NASH), which is causally related to cirrhosis
and cardiovascular disease (CVD) mortality. There is no generally accepted effective treatment for
NAFLD/NASH. Chronic kidney disease (CKD) is relatively common and might co-exist with
NAFLD/NASH, aggravate one another, and increase CVD risk.
Common therapies could improve outcome. Potent statins at high doses, such as atorvastatin and rosuvastatin,
ameliorate NAFLD/NASH and reduce the mortality rates by half as compared with those on
the same statins but without liver disease and CVD-related events are reduced by atorvastatin for patients
with all stages of CKD.
The new anti-diabetic medication classes, the sodium-glucose co-transporter-2 inhibitors (SGLT2i) and
the glucagon like peptide receptor agonists (GLP1 RA) for patients with NAFLD/NASH, CKD and
T2DM are useful because they ameliorate NAFLD/NASH, delay the evolution of CKD, and substantially
reduce CVD and all-cause mortality.
Thus, the common use of high potency statins, renin-angiotensin-aldosterone system inhibitors, and the
newer anti-diabetic agents increase compliance and can substantially reduce CVD risk and the rate of
liver and kidney adverse events, improving quality of life and survival.
