Research Awards Recipients

Lay Abstract

Purpose: Non-alcoholic fatty liver disease (NAFLD) affects one in four Canadians having NAFLD. It is the “liver part” of what is called metabolic syndrome, which also includes high blood pressure, diabetes, and high cholesterol. This group of conditions come together more often in people with kidney disease, including kidney transplant patients, than in others, but we do not have much information about NAFLD in kidney transplant patients. These patients need drugs that dampen the immune system to prevent transplant rejection, but these drugs may add to the risk of metabolic syndrome. NAFLD is associated with an increased risk of heart disease, which is the top cause of death in kidney transplant recipients. Importantly, in early stages, NAFLD can be cured. However, once scarring develops, it may become irreversible. Therefore, there is an important need to understand the burden NAFLD imposes on Canadian kidney transplant recipients, document how it progresses over time, and identify opportunities to prevent the complications associated with it in this population. Procedure: We will document how many kidney transplant candidates and recipients from McGill University Health Centre have NAFLD. To diagnose and follow NAFLD and its progression, we will use non-invasive tools like abdominal ultrasounds and blood test results. We will connect these test results with clinical problems that develop in transplant patients such as post-transplant diabetes or the kidney transplant not working well, even to the point of returning to dialysis. We will also conduct in-depth interviews with a diverse group of kidney transplant recipients with and without NAFLD to explore possible barriers and facilitators of uptake of healthy dietary choices and physical activity capable of preventing NAFLD and its progression. Outcome: We will figure out how important NAFLD is in kidney transplant recipients. We will identify the preferred non-invasive tools to diagnose it (abdominal ultrasounds or blood tests) and study risk factors like immunosuppression agents that promote its progression. Finally, we will study the complications that arise because of it, and what actions patients could take with regards to their diet and exercise to prevents those. Relevance to patients: The reversible nature of NAFLD in its early stages, and the severity of the complications arising as it progresses, suggest that timely diagnosis and treatment may help slow its progression. Our study will provide evidence that can directly affect the care of kidney transplant recipients and improve patients’ quantity and quality of life with reduced burdens related to having multiple health concerns, drug burden, need for dialysis care, and personal health expenditures.