S4-18.3 – Positive Engagement with Biofeedback and NAFLD/NASH in Chronic Kidney Patients

S4-18.3 - Positive Engagement with Biofeedback and NAFLD/NASH in Chronic Kidney Patients
Cyrielle Caussy joins the Surfers to talk about how patients can be motivated by biofeedback to improve both liver health and overall condition. Following, the group discusses how specific phenotypes in chronic kidney patients can be targeted for high risk of NAFLD/NASH.

As part of our ongoing dialogue around clinical care pathways and the complex of metabolic diseases, SurfingNASH dedicates a session to focus on the key relationship and interplay between endocrinology and hepatology.

This topic rings familiar in the Rising Tide series, our podcast for frontline education, where Ken Cusi often notes the need for endocrinologists to become comfortable diagnosing Fatty Liver disease (and prescribing pioglitazone) and for hepatologists to become more comfortable prescribing GLP-1s. To expand on these critical ideas with the SurfingNASH community, Jörn Schattenberg, Louise Campbell and Roger Green are joined by Cyrielle Caussy, Professor of Nutrition and Endocrinologist-Diabetologist at Lyon 1 University and Lyon South Hospital, Hospices Civils de Lyon (France). Cyrielle is an expert in the clinical care of metabolic disease, including type 2 diabetes, obesity and NAFLD, and is leading a clinical and research program focused on metabolic liver disease at the Lyon Hepatology Institute.

This conversation starts with Louise’s question around how patients respond when informed of liver-related conditions in the endocrinology clinic setting. Cyrielle shares a positive anecdote where a patient with obesity and Type-2 diabetes ultimately managed to improve weight in striving for a healthier liver status. For many patients, the notion that improving liver health will holistically improve their overall condition is a powerful and resonating source of motivation. Jörn notes this sort of positive relationship around biofeedback to be a recurring subject on the podcast. From here, Louise steers conversation to consider Cyrielle’s Paris NASH presentation which investigates how different phenotypes for chronic kidney patients may imply elevated risk of NAFLD and NASH. After elaborating briefly on this note, Cyrielle concludes with a powerful takeaway: “classifying your patient based on the presence of NAFLD or not is also classifying your patient regarding the prognosis of diabetes and not only the prognosis of liver.” As the session winds down, Jörn adds fascinating thoughts around the mechanisms and relationship between staging of liver disease, fibrogenesis and the metabolic drive that concerns the kidneys in parallel.

If you enjoy the episode, have questions or interest around endocrinology and Fatty Liver disease, we kindly ask that you submit reviews wherever you download the discourse. Alternatively, you can write to us directly at questions@SurfingNASH.com.

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