Non-alcoholic fatty liver disease (NAFLD) and chronic kidney disease (CKD) are worldwide public health problems, affecting up to 25-30% (NAFLD), and up to 10-15% (CKD) of the general population. Recently, it has also been established that there is a strong association between NAFLD and CKD, regardless of the presence of potential confounding diseases such as obesity, hypertension and type 2 diabetes. Since NAFLD and CKD are both common diseases that often occur alongside other metabolic conditions, such as type 2 diabetes or metabolic syndrome, elucidating the relative impact of NAFLD on the risk of incident CKD presents a substantial challenge for investigators working in this research field. A growing body of epidemiological evidence suggests that NAFLD is an independent risk factor for CKD and recent evidence also suggests that associated factors such as metabolic syndrome, dysbiosis, unhealthy diets, platelet activation and processes associated with ageing could also contribute mechanisms linking NAFLD and CKD. This narrative review provides an overview of the literature on: a) the evidence for an association and causal link between NAFLD and CKD and b) the underlying mechanisms by which NAFLD (and factors strongly linked with NAFLD) may increase the risk of developing CKD.

中文翻译：

---

NAFLD 是慢性肾病的驱动因素

非酒精性脂肪性肝病 (NAFLD) 和慢性肾病 (CKD) 是全球性的公共卫生问题，影响了高达 25-30% (NAFLD) 和高达 10-15% (CKD) 的一般人群。最近，还确定 NAFLD 和 CKD 之间存在很强的关联，而不管是否存在潜在的混杂疾病，如肥胖、高血压和 2 型糖尿病。由于 NAFLD 和 CKD 都是常见疾病，经常与其他代谢疾病（如 2 型糖尿病或代谢综合征）同时发生，阐明 NAFLD 对 CKD 发生风险的相对影响对在该研究领域工作的研究人员来说是一个巨大的挑战。越来越多的流行病学证据表明，NAFLD 是 CKD 的独立危险因素，最近的证据还表明，代谢综合征、生态失调、不健康饮食、血小板活化和与衰老相关的过程等相关因素也可能有助于将 NAFLD 与 CKD 联系起来。本叙述性综述概述了以下方面的文献：a) NAFLD 和 CKD 之间关联和因果关系的证据，以及 b) NAFLD（以及与 NAFLD 密切相关的因素）可能增加患 CKD 风险的潜在机制。