Non-alcoholic fatty liver disease (NAFLD) is becoming the leading cause for liver transplant, and it is the most rapidly growing indication for simultaneous liver-kidney transplant in USA (Singhal AK et al. Transplantation 2016). There is increasing evidence from epidemiological studies suggesting a link between NAFLD and chronic kidney disease. Despite this association, the clinical burden of NAFLD in kidney transplant (KT) is unknown. Therefore the aim of this study is to determine the prevalence of NAFLD in this population. Methods: We conducted a retrospective analysis of pre-transplant data of candidates who received a kidney transplant during the study period (Jan 2014 – Dec 2014). Data extracted from our transplant registry included kidney diagnosis, age, gender, race/ethnicity, laboratory tests and imaging. We included all adults (>18 years) and we excluded re-transplants, dual organ transplant, polycystic kidney/liver and living donor transplant. Diagnosis of NAFLD was based on the presence of hepatic steatosis on imaging in the absence of ETOH use. Results: The study population (n=94) had an age range 18-75 years, predominantly male (58%) with the ethnic composition of Caucasian 51(54%), Blacks 26 (28%), Hispanic 11(12%) and Others (6%). Etiology of ESRD was DM 34 (36%), HTN 31(33%), FGS 10 (11%) and others (20%). The presence of NAFLD was found in 22% of our study population. There was no significant difference in age, gender or ethnicity but we found a significant association between DM and the presence of NAFLD (p=0.034). The prevalence of NAFLD among those with DM was 32% compared to 13% in non-DM. Furthermore, DM was associated with a 2.4-fold increased risk of NAFLD (OR 2.42, 95% CI 1.08 – 5.44; p=0.031) Conclusion: NAFLD is under-recognized and underdiagnosed in KT. With the known liver-related morbidity and mortality associated with NAFLD and the estimated ~15,000 adult KT annually in the USA, a heightened awareness is needed among nephrologists and other health care providers involved in the care of these patients. Furthermore, future studies are indicated to determine the utility of screening for NAFLD in the identified high-risk KT subgroup i.e. DM.

CITATION INFORMATION: Kemmer N, Buggs J. NAFLD in Kidney Transplant Candidates. Am J Transplant. 2017;17 (suppl 3).

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