The risk factors for cardiovascular disease and chronic kidney disease in patients with nonalcoholic fatty liver disease in Saudi Arabia.

Objectives: To identify potential risk factors for chronic kidney disease (CKD) and cardiovascular disease (CVD) in Saudi Arabian patients with non-alcoholic fatty liver disease (NAFLD).

Methods: A 6-year prospective cohort study was carried out from January 2018 to January 2023, enrolling 1,500 patients. Data were initially collected between January 2018-2019, and follow-up assessments were carried out annually from 2020-2023. Patients were evaluated using biomarker analyses, and medical records were reviewed to assess the incidence of CVD and CKD. Biomarker levels, including blood creatinine, urine albumin, glomerular filtration rate (GFR), atherogenic index of plasma (AIP), and other key parameters, were monitored throughout the study.

Results: Of the 1500 patients, 735 (49%) were diagnosed with NAFLD in 2018, while 765 (51%) did not have the condition. Compared to non-NAFLD patients, those with NAFLD exhibited elevated blood creatinine levels, lower GFR, and higher urine albumin, a key marker of kidney damage that is strongly linked to accelerated CKD progression and increased cardiovascular risk. Furthermore, NAFLD patients had a significantly higher AIP. Over the 4-year follow-up, these individuals showed a notable rise in the incidence of CKD and CVD.

Conclusion: Non-alcoholic fatty liver disease is associated with alterations in lipid profiles, elevated high-sensitivity C-reactive protein (hs-CRP), and elevated aspartate aminotransferase (AST), all of which may contribute to early CKD and CVD development. Older, obese individuals with NAFLD, high triglyceride, AST, and hs-CRP levels are at an elevated risk for these diseases.