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The Co-Existence of NASH and Chronic Kidney Disease Boosts Cardiovascular Risk: Are there any Common Therapeutic Options?

[ Vol. 16 , Issue. 3 ]


Marianna Papademetriou, Vasilios G. Athyros, Eleni Geladari, Michael Doumas, Costas Tsioufis and Vasilios Papademetriou*   Pages 254 - 268 ( 15 )


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.


Non-alcoholic fatty liver disease, non-alcoholic steatohepatitis, chronic kidney disease, type 2 diabetes, cardiovascular disease, statins, ACE-I, ARBs, SGLT2i, GLP1 RA.


New York University Langone Medical Center, New York, NY, Aristotle University, Thessaloniki, VAMC and Georgetown University, Washington, DC, Aristotle University, Thessaloniki, Kapodestrian University, Athens, VAMC and Georgetown University, Washington, DC

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