Park H, et al. - Researchers carried out a retrospective cohort analysis of the Truven Health MarketScan Database (2006-2015) to determine the longitudinal connection of non-alcoholic fatty liver disease (NAFLD) with the development of advanced chronic kidney disease (CKD) in the United States. Using Cox proportional hazards models, they compared the risk of developing CKD stages 3-5 in NAFLD vs non-NAFLD patients, identified by ICD-9 codes, after 1:3 propensity score (PS) matching. In all, 5,766 and 8,655 new advanced (stage 3-5) CKD cases were identified in a cohort of 262,619 newly diagnosed NAFLD patients and 769,878 PS-matched non-NAFLD patients, respectively. In NAFLD and non-NAFLD groups, the crude CKD incidence rate was 8.2 and 5.5 per 1,000 person-years, respectively. Compensated cirrhosis and decompensated cirrhosis increased the risk of CKD in NAFLD. NAFLD was independently linked to an increased risk of advanced development of CKD, suggesting that screening of renal function and regular monitoring in this population are needed.