Objective To determine if radiologically diagnosed nonalcoholic fatty liver disease (NAFLD) is an independent risk factor for nephrolithiasis using data from National Health and Nutrition Examination Survey III (NHANES III). Patients and Methods NHANES III participants aged 20-74 years who underwent hepatobiliary ultrasound were classified as with NAFLD (moderate or severe hepatic steatosis in absence of other known causes of liver disease; n = 2,498) or without NAFLD (controls; n = 9,361). Risk of nephrolithiasis due to NAFLD was estimated using logistic regression with propensity score adjustment. Secondary outcomes included medical stone management, lithotripsy, and surgical stone removal. Results Participants with NAFLD were older (48.7 ± 0.4 vs. 43.3 ± 0.3 years, p < .001) and exhibited greater prevalence of all components of metabolic syndrome: obesity (48% vs. 21%), impaired glucose tolerance (17% vs. 11%), diabetes mellitus (15% vs. 6%), hypertension (36% vs. 24%), and gout (4% vs. 2%) (all p < .001). After adjusting for demographic, lifestyle, and metabolic factors, NAFLD was associated with increased risk nephrolithiasis (odds ratio, OR = 1.29, 95% confidence interval, CI [1.02, 1.61], p = .03). The association persisted in females (OR = 1.65, 95% CI [1.17, 2.32], p = .004) but not in males (OR = 1.04, 95% CI [0.77, 1.40], p = .80). NAFLD was not associated with increased occurrence of medical management (OR = 1.31, 95% CI [0.84, 2.05], p = .24), lithotripsy (OR = 1.61, 95% CI [0.83, 3.33], p = .20), or surgical stone removal (OR = 0.83, 95% CI [0.48, 1.44], p = .52). Conclusions In a large United States population-based cross-sectional analysis, NAFLD was found to be associated with increased risk of nephrolithiasis in women after adjusting for demographic, clinical, and metabolic factors.
Journal of endourology. 2020 Jun 22 [Epub ahead of print]
Rourke Douglas Decker, Eric M Ghiraldi, Alexandra H Weiss, John P Gaughan, Justin I Friedlander
Rowan University School of Osteopathic Medicine, 43987, Stratford, New Jersey, United States; ., Albert Einstein Healthcare Network, 6528, Department of Urology, Philadelphia, Pennsylvania, United States; ., Cooper University Health Care, 2202, Division of Gastroenterology and Liver Diseases, Camden, New Jersey, United States; ., Cooper University Health Care, 2202, Cooper Research Institute, Camden, New Jersey, United States; ., Albert Einstein Healthcare Network, 6528, Department of Urology, Philadelphia, Pennsylvania, United States.