27 Exploring the liver kidney axis in the Ghanaian population: the RODAM-Prospective study

Abstract EP3.3, e-Poster Terminal 3, September 4, 2025, 10:05 - 10:25 Aim Liver-kidney axis plays a crucial role in overall health, yet its role in chronic kidney disease (CKD) is underexplored. We aimed to examined the associations of markers of liver cell damage (gamma-glutamyl transferase [GGT], alanine aminotransferase [ALT], aspartate aminotransferase [AST]) and fatty liver disease (fatty liver index [FLI]) with CKD incidence among Ghanaians. Methods We utilized data from prospective RODAM study (baseline 2015, follow-up 2021). Biomarkers of liver cell damage were categorized into elevated or non-elevated based on established clinical practice/literature. CKD incidence was defined by KDIGO criteria. FLI was calculated using standard Bedogni formula. Robust Poisson regressions were used to evaluate associations of baseline liver markers (2015) with CKD incidence (2021), adjusting for demographics, lifestyle, and comorbidities. Subgroup analyses were conducted by age, sex, and migration status. Results 1,832 participants were included. Elevated GGT, ALT, and AST levels were positively associated with CKD incidence six years later [incidence rate ratios (IRRs) 1.45, 95% CI 1.02–2.03; 2.17 95% CI 1.17–3.70; 1.69 95% CI 1.19–2.37, respectively]. High FLI scores were also positively associated with CKD incidence at follow-up [IRR 1.92, 95% CI 1.14–3.18]. Subgroup analyses revealed that participants aged ≥40 years, females, and urban residents had higher CKD risk from elevated GGT levels, while no subgroup differences were observed for other liver markers. Conclusion Biomarkers of liver cell damage and fatty liver disease are significant predictors of CKD risk in a West African population. Our findings highlight potential value of liver health as an indicator of future CKD risk.