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Kidney Week

Abstract: FR-PO1132

Association between Median Liver Stiffness and Proteinuria among US Adults: NHANES, 2017-2020

Session Information

Category: CKD (Non-Dialysis)

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

Authors

  • Rodsom, Kamonluk, University of California Irvine School of Medicine, Irvine, California, United States
  • Kookanok, Chutawat, University of California Irvine School of Medicine, Irvine, United States
  • Thotsiri, Sansanee, Mahidol University Faculty of Medicine Ramathibodi Hospital, Bangkok, Thailand
  • Poochanasri, Methavee, Phramongkutklao College of Medicine, Bangkok, Thailand
  • Kulthamrongsri, Narathorn, Mahidol University Faculty of Medicine Siriraj Hospital, Bangkok, Thailand
  • Rochanaroon, Voramol, Rayong Hospital, Tha Pradu, Rayong, Thailand
  • Mongkolporn, Ariya, Thammasart University Faculty of Science and Technology, Khlong Nueng, Pathum Thani, Thailand
  • Sodsri, Tulaton, Mahidol University Faculty of Medicine Ramathibodi Hospital, Bangkok, Thailand
  • Sinkajarern, Varissara, Vimut Hospital, Bangkok, Thailand
  • Phoonakh, Thutpharritchn, Vimut Hospital, Bangkok, Thailand
  • Tantisattamo, Ekamol, University of California Irvine School of Medicine, Irvine, California, United States
Background

Liver stiffness is linked to CKD and proteinuria. There is limited national-scale evidence on the impact of gender on this relationship. This study explores if gender influences the risk of proteinuria associated with liver stiffness.

Methods

A national study involving 6,525 adults, using NHANES 2017-2020 ,investigated the relationship between median liver stiffness and ACR. Liver stiffness was categorized into four fibrosis scores with cut-off points at 2-7, 7-11, 11-19, and ≥19 kPa. Three linear regression (LR) models were utilized,considering each gender subgroups [Table 1].

Results

Median liver stiffness was categorized into four fibrosis scores (F1 through F4) among male and female participants. For males, the majority were classified as F1, with 2,620 individuals (84.57%). This was followed by 355 individuals (11.46%) with F2, 99 individuals (3.20%) with F3, and 24 individuals (0.77%) with F4. Similarly, most females were classified as F1, with 3,019 individuals (88.15%). This was followed by 296 individuals (8.64%) with F2, 91 individuals (2.66%) with F3, and 19 individuals (0.55%) with F4. In the final adjusted LR model, the ACR increased significantly for each unit increase in median liver stiffness, by 0.76 (95% CI: 0.13-1.40) in the total group and by 1.74 (95% CI: 0.70-2.79) in female [Table 1].

Conclusion

A significant positive correlation between ACR and median liver stiffness, influenced by gender, was found among US adults. This suggests that monitoring kidney function and proteinuria, especially in women with a history of liver disease, is crucial for the early detection of kidney injury.

 Model 1Model 2Model 3
 β-Coefficients(95%CI)P-valueβ-Coefficients(95%CI)P-valueβ-Coefficients(95%CI)P-value
Total1.48 (1.06, 1.91)<0.0010.99 (0.36, 1.63)<0.0020.76 (0.13, 1.40)<0.018
Male1.54 (0.97, 2.11)<0.0010.51 (-0.29, 1.31)0.2120.28 (-0.52, 1.08)0.494
Female1.66 (1.04, 2.29)<0.0011.92 (0.87, 2.96)<0.0011.74 (0.70, 2.79)0.001

Fig 1: Table of correlation analysis between Median Liver Stiffness and Albumin Creatinine Ratio (ACR) using three different logistic regression models. The first model included only Median Liver Stiffness, the second model added age, race, smoking, and drinking, and the third model further included dyslipidemia, hypertension, diabetes, coronary artery disease, congestive heart failure, and stroke.