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

Publisher: Bentham Science Publishers

E-ISSN: 1875-6212|16|3|254-268

ISSN: 1570-1611

Source: Current Vascular Pharmacology, Vol.16, Iss.3, 2018-03, pp. : 254-268

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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 cirrhosisand cardiovascular disease (CVD) mortality. There is no generally accepted effective treatment forNAFLD/NASH. Chronic kidney disease (CKD) is relatively common and might co-exist withNAFLD/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 onthe same statins but without liver disease and CVD-related events are reduced by atorvastatin for patientswith all stages of CKD.

The new anti-diabetic medication classes, the sodium-glucose co-transporter-2 inhibitors (SGLT2i) andthe glucagon like peptide receptor agonists (GLP1 RA) for patients with NAFLD/NASH, CKD andT2DM are useful because they ameliorate NAFLD/NASH, delay the evolution of CKD, and substantiallyreduce CVD and all-cause mortality.

Thus, the common use of high potency statins, renin-angiotensin-aldosterone system inhibitors, and thenewer anti-diabetic agents increase compliance and can substantially reduce CVD risk and the rate ofliver and kidney adverse events, improving quality of life and survival.