Association of elevated serum aminotransferase levels with chronic kidney disease measures: hispanic community health study/study of latinos

BMC Nephrol. 2021 Sep 7;22(1):302. doi: 10.1186/s12882-021-02483-y.


Background: Previous studies have shown an association between non-alcoholic fatty liver disease (NAFLD) and chronic kidney disease (CKD), but it is unclear whether the association is independent of metabolic syndrome.

Methods: Data from 13,006 participants aged 18 to 74 years in the Hispanic Community Health Study/Study of Latinos (HCHS/SOL) without viral hepatitis, excessive alcohol consumption, or high transferrin saturation levels were analyzed. Suspected NAFLD was defined as presence of sex-specific elevations in serum aminotransferase levels (aspartate aminotransferase (AST) > 37 U/L or alanine aminotransferase (ALT) > 40 U/L for men and AST or ALT > 31 U/L for women). Logistic regression was used to examine cross-sectional associations of elevated serum aminotransferase levels with low estimated glomerular filtration rate (eGFR < 60 ml/min/1.73 m2 based on cystatin C), and with high urinary albumin-to-creatinine ratio (UACR) (> 17 mg/g in men and > 25 mg/ g in women) in separate models adjusting for demographic characteristics and metabolic syndrome.

Results: Mean (SD) age was 41 (0.27) years, and 45 % were male. Elevated serum aminotransferase levels were noted in 18.8 % of the population and were associated with greater odds of high UACR (OR = 1.31; 95 % CI = 1.10, 1.56) after adjusting for demographic characteristics; this association became non-significant after adjustment for metabolic syndrome (OR = 1.11, 95 % CI = 0.92, 1.33). In contrast, elevated serum aminotransferase levels were not associated with low eGFR (odds ratio (OR) = 0.73; 95 % confidence interval (CI) = 0.45, 1.18) after adjusting for covariates.

Conclusions: In this sample of diverse U.S. Hispanic Latino adults, elevated serum aminotransferase levels were not independently associated with measures of CKD.

Keywords: Aminotransferase levels; Chronic kidney disease; Hispanics/Latinos; NAFLD; Obesity; Race/ethnicity.

MeSH terms

  • Adult
  • Alanine Transaminase / blood*
  • Albuminuria
  • Aspartate Aminotransferases / blood*
  • Cohort Studies
  • Creatinine / urine
  • Female
  • Glomerular Filtration Rate
  • Hispanic or Latino*
  • Humans
  • Logistic Models
  • Male
  • Metabolic Syndrome / complications*
  • Metabolic Syndrome / ethnology
  • Non-alcoholic Fatty Liver Disease / complications*
  • Non-alcoholic Fatty Liver Disease / ethnology
  • Odds Ratio
  • Renal Insufficiency, Chronic / blood
  • Renal Insufficiency, Chronic / complications
  • Renal Insufficiency, Chronic / ethnology*
  • Risk Factors


  • Creatinine
  • Aspartate Aminotransferases
  • Alanine Transaminase