P-83 RELEVANCE OF RENAL CHANGES IN A LARGE SERIES OF SEVERELY OBESE PATIENTS WITH METABOLIC ASSOCIATED FATTY LIVER DISEASE

Introduction

Metabolic associated fatty liver disease (MAFLD) is the most common cause of chronic liver disease worldwide. Recently, the relationship between MAFLD and chronic kidney disease has raised more interest because this relationship may be an additional factor that interferes with the clinical course and prognosis of this frequent liver disease.

Aim

To evaluate the prevalence and clinical relevance of renal changes in severely obese patients. with MAFLD.

Methodology

A cross-sectional study was conducted with obese patients (BMI > 35 Kg/m²) and MAFLD coming from a surgical treatment of obesity center between 2015 and 2018. MAFLD criteria: presence of steatosis (abdominal ultrasound); in addition to one of the following three criteria, overweight/obesity, type 2 diabetes mellitus (T2DM), and other features of metabolic disfunction. FIB-4 and APRI scores were used to define presence or evaluate liver fibrosis. Glomerular filtration rate was estimated by the CKD-EPI equation and the normal was considered ≥ 90 and <120 mL/min/1,73 m².

Results

A total of 394 individuals with MAFLD were included. Of these, 279 cases were female (70.8%) with a mean age of 36.8±10 years. Arterial hypertension was observed in 162(41.1%) of the subjects and 66 (16.8 %) had T2DM. Glomerular filtration rate of 60-89 ml/min was observed in 57 (14.5%), 31 of these were not arterial hypertension (54.4%) and 46 (80.7%) did no presented T2DM. Thirteen (3.3%) of the obese cases with MAFLD already had advanced fibrosis.

Conclusion

The results show that severely obese with MAFLD may present renal alterations without other metabolic disfunction. The data also suggest that attention should be given to this complication in the obese patients, that can be the only risk factor to MAFLD.