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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 ]

Author(s):

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

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.

Keywords:

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

Affiliation:

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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