Assessment of Renal Changes in Patients With Non Alcoholic Fatty Liver Disease

The safety and scientific validity of this study is the responsibility of the study sponsor and investigators. Listing a study does not mean it has been evaluated by the U.S. Federal Government. Know the risks and potential benefits of clinical studies and talk to your health care provider before participating. Read our disclaimer for details. Identifier: NCT03487068
Recruitment Status : Not yet recruiting
First Posted : April 3, 2018
Last Update Posted : April 4, 2018
Information provided by (Responsible Party):
Maiada Mohie Eldin Ibrahim, Assiut University

Brief Summary:
Assess the renal changes in patients with non-alcoholic fatty liver (NAFLD).

Condition or disease Intervention/treatment Phase
Non-Alcoholic Fatty Liver Disease Chronic Kidney Diseases Device: The FibroScan device Not Applicable

Detailed Description:
  • Non-alcoholic fatty liver disease (NAFLD) is the accumulation of fat (>5%) in liver cells in the absence of excessive alcohol intake or other causes of liver disease. The histologic spectrum of NAFLD ranges from simple steatosis to non-alcoholic steatohepatitis (NASH), liver fibrosis, and cirrhosis. This disease affects up to 30% of the general population in Western countries, especially in patients with metabolic syndrome, obesity, and type II diabetes.
  • Accumulating epidemiologic evidence indicates that NAFLD not only affects the liver but also increases the risk of extra-hepatic diseases such as type 2 diabetes mellitus, metabolic syndrome, hypertension, cardiovascular or cerebrovascular diseases, and chronic kidney disease.
  • Chronic kidney disease (CKD) is defined by decreased estimated glomerular filtration rate (eGFR) and/or the presence of significant proteinuria. Its prevalence is ~ 4.3 - 13% in general population, but it is expected to increase and ~ 50% of these patients develop end-stage renal disease. Recently, CKD is significantly higher in patients with NAFLD than patients without.
  • Several studies have demonstrated that NAFLD independently contributes to increasing the risk of CKD where NAFLD and CKD may share many common cardio-metabolic risk factors e.g. insulin resistance, chronic inflammation, and obesity.
  • The exact pathophysiologic mechanisms linking NAFLD to CKD are not completely understood, however, there is increased production of various proinflammatory cytokines, reactive oxygen species, TNF-α, C-reactive protein (CRP), and IL-6 by hepatocytes and non-parenchymal cells (Kupffer cells and hepatic stellate cells) that can link NAFLD and CKD. In addition, altered rennin-angiotensin system activation can be involved.
  • Several western studies had evaluated the relationship between NAFLD and CKD and shown the prevalence of CKD in NAFLD patients between 4 - 40%.
  • An analysis of the United Network Organ Sharing (UNOS) data base during the years (2002-2011) revealed that 35% of the patients transplanted for NAFLD-related cirrhosis progressed to stage 3-4 CKD within 2 years after liver transplantation in comparison to 10% of patients transplanted for other etiologies.
  • Despite these findings CKDs often goes unrecognized and The Third National Health and Nutrition survey (NHANESIII), among all individuals with moderately decreased GFR (less than 60ml/min; stage 3) reported the awareness was approximately 8%.
  • There is still very little prospective studies and data linking NAFLD to CKD, and it is lacking in the middle east region.

Study Type : Interventional  (Clinical Trial)
Estimated Enrollment : 50 participants
Intervention Model: Single Group Assignment
Masking: None (Open Label)
Primary Purpose: Diagnostic
Official Title: Assessment of Renal Changes in Patients With Non Alcoholic Fatty Liver Disease
Estimated Study Start Date : April 30, 2018
Estimated Primary Completion Date : April 30, 2019
Estimated Study Completion Date : May 30, 2019

Arm Intervention/treatment
Patients with NAFLD Device: The FibroScan device
The Fibroscan device (Echosens) works by measuring shear wave velocity. In this technique, a 50-MHz wave is passed into the liver from a small transducer on the end of an ultrasound probe. The probe also has a transducer on the end that can measure the velocity of the shear wave (in meters per second) as this wave passes through the liver. The shear wave velocity can then be converted into liver stiffness, which is expressed in kilopascals. Essentially, the technology measures the velocity of the sound wave passing through the liver and then converts that measurement into a liver stiffness measurement; the entire process is often referred to as liver ultrasonographic elastography.

Primary Outcome Measures :
  1. Assessment of renal changes in patients with non-alcoholic fatty liver disease [ Time Frame: baseline ]
    Measuring renal changes especially glomerular and interstitial pathologies which will lead to chronic kidney disease in patients with non alcoholic fatty liver disease.

Information from the National Library of Medicine

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Ages Eligible for Study:   18 Years to 90 Years   (Adult, Older Adult)
Sexes Eligible for Study:   All
Accepts Healthy Volunteers:   No

Inclusion Criteria:

•Patients diagnosed as NAFLD by abdominal ultrasonography, Fibroscan, NAFLD fibrosis score and FIB-4 score

Exclusion Criteria:

  • Patients with diabetes and/or hypertension.
  • Patients with chronic renal disease.
  • Patients with urinary tract infections.
  • Patients on medications affecting the kidney (eg: NSAIDs,..etc)
  • Patients with chronic liver disease other than NAFLD (chronic hepatitis; viral B,C, autoimmune etc).
  • Alcohol consumption.

Information from the National Library of Medicine

To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor.

Please refer to this study by its identifier (NCT number): NCT03487068

Contact: Maiada M Ibrahim, Master 01068388643
Contact: Mohamed El Taher, PHD 01005602251

Sponsors and Collaborators
Assiut University

Responsible Party: Maiada Mohie Eldin Ibrahim, Resident Doctor Of Gastroenterology, Assiut University Identifier: NCT03487068     History of Changes
Other Study ID Numbers: Renal changes with NAFLD
First Posted: April 3, 2018    Key Record Dates
Last Update Posted: April 4, 2018
Last Verified: March 2018
Individual Participant Data (IPD) Sharing Statement:
Plan to Share IPD: No

Studies a U.S. FDA-regulated Drug Product: No
Studies a U.S. FDA-regulated Device Product: No

Additional relevant MeSH terms:
Kidney Diseases
Renal Insufficiency, Chronic
Liver Diseases
Fatty Liver
Non-alcoholic Fatty Liver Disease
Urologic Diseases
Renal Insufficiency
Digestive System Diseases