Crosstalk between kidney and liver in non-alcoholic fatty liver disease: mechanisms and therapeutic approaches

Arch Physiol Biochem. 2022 Aug;128(4):1024-1038. doi: 10.1080/13813455.2020.1745851. Epub 2020 Mar 30.

Abstract

Liver and kidney are vital organs that maintain homeostasis and injury to either of them triggers pathogenic pathways affecting the other. For example, non-alcoholic fatty liver disease (NAFLD) promotes the progression of chronic kidney disease (CKD), vice versa acute kidney injury (AKI) endorses the induction and progression of liver dysfunction. Progress in clinical and basic research suggest a role of excessive fructose intake, insulin resistance, inflammatory cytokines production, activation of the renin-angiotensin system, redox imbalance, and their impact on epigenetic regulation of gene expression in this context. Recent developments in experimental and clinical research have identified several biochemical and molecular pathways for AKI-liver interaction, including altered liver enzymes profile, metabolic acidosis, oxidative stress, activation of inflammatory and regulated cell death pathways. This review focuses on the current preclinical and clinical findings on kidney-liver crosstalk in NAFLD-CKD and AKI-liver dysfunction settings and highlights potential molecular mechanisms and therapeutic targets.

Keywords: Non-alcoholic fatty liver disease; acute kidney injury; chronic kidney disease; crosstalk; liver dysfunction.

Publication types

  • Review

MeSH terms

  • Acute Kidney Injury* / etiology
  • Acute Kidney Injury* / metabolism
  • Acute Kidney Injury* / therapy
  • Epigenesis, Genetic
  • Humans
  • Kidney / metabolism
  • Liver / metabolism
  • Non-alcoholic Fatty Liver Disease* / metabolism
  • Renal Insufficiency, Chronic* / complications
  • Renal Insufficiency, Chronic* / metabolism