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Abstract: SA-PO1124

Fibrotic Burden in Patients with Hepatitis B Virus-Related Cirrhosis Is Independently Associated with Poorer Kidney Outcomes

Session Information

Category: CKD (Non-Dialysis)

  • 2301 CKD (Non-Dialysis): Epidemiology, Risk Factors, and Prevention

Authors

  • Jung, Chan-Young, Asan Medical Center, Seoul, Korea (the Republic of)
  • Jung, Hui-Yun, Yonsei University College of Medicine, Seoul, Korea (the Republic of)
  • Kim, Beom Seok, Yonsei University College of Medicine, Seoul, Korea (the Republic of)
Background

Liver cirrhosis and chronic kidney disease (CKD) are chronic conditions that share cardiometabolic risk factors and pathogenic mechanisms. We investigated whether higher fibrotic burden was independently associated with poorer kidney outcomes in patients with hepatitis B virus (HBV)-related cirrhosis.

Methods

A total of 1,691 patients with HBV-related cirrhosis without baseline CKD who underwent transient elastography (TE) between March 2012 and August 2018 were selected. The study outcome was the composite of development of incident CKD, defined as the occurrence of estimated glomerular filtration rate (eGFR) <60 mL/min/1.73m2 or proteinuria (≥1+ on dipstick) on two consecutive measurements during follow-up, 50% decline in eGFR or onset of end-stage kidney disease, or all-cause mortality.

Results

The mean age was 53.4 years and 1,030 (60.9%) patients were male. During 8,379 person-years of follow-up (median 5.2 years), 60 (3.5%) patients experienced study outcomes. When stratified according to TE-defined fibrotic burden, multivariable Cox models revealed that risk of poorer kidney outcomes was 2.77-fold (95% CI, 1.16-6.63, P<0.001) higher in patients with cirrhotic range liver stiffness (≥11.7 kPa), compared to those without significant liver fibrosis (<7.9 kPa).

Conclusion

Higher fibrotic burden assessed using TE was independently associated with poorer kidney outcomes in patients with HBV-related cirrhosis.

Figure 1. Cumulative incidence of adverse kidney events by fibrotic burden. Log-rank test P < 0.001. Abbreviations: TE, transient elastography.