Fatty liver favors the formation of kidney stones – medical practice

Fatty liver increases the risk of kidney stones

Non-alcoholic fatty liver disease (NAFLD) is the most common liver disease in industrialized countries like Germany. Fatty liver is said to affect between 20 and 40 percent of all adults. It is three out of four among people with overweight and / or type 2 diabetes. The incidence has been increasing for years. One of the possible consequences is kidney disease and the formation of kidney stones. So far it has not been clear why fatty liver favors the development of kidney stones. A German research team has now been able to clarify this.

Researchers at the Leibniz Institute for Labor Research at TU Dortmund University (IfADo) have shown in a current study why fatty liver disease promotes the formation of kidney stones. Apparently a metabolic process is disturbed by the fatty liver, which leads to an accumulation of oxalate. In combination with calcium, the salt can form kidney stones. The research results were recently published in the renowned specialist journal “Cell Reports” presented.

Oxalate is a metabolic product of the liver

Oxalate, i.e. the salts and esters of oxalic acid, can not only be absorbed through foods such as nuts, Swiss chard, rhubarb and spinach, but are also formed as a metabolic product in the liver. The oxalate is excreted by the kidneys in the urine.

Metabolism is disturbed in fatty liver

As the working group found out, fatty liver disease leads to a disturbed metabolic process in the liver. While the enzyme alanine glyoxylate aminotransferase (AGXT) prevents oxalate from building up in a healthy liver, AGXT is insufficient in fatty liver. The enzyme can therefore not perform its function sufficiently. The lack of AGXT results in an accumulation of oxalate.

Oxalate increases the risk of kidney stones

When oxalate meets calcium, calcium salts (calcium oxalate) are formed. Initially, the salts appear as small, sand-like stones, from which larger kidney stones form over time. An increased oxalate concentration in the urine is therefore also associated with an increased risk of the formation of kidney stones and kidney damage. According to the research team, kidney stones are usually not life threatening, but they can be the cause of chronic kidney disease.

Other risks from fatty liver

In most cases, fatty liver does not cause any serious symptoms at first, which is why it is often not recognized. If the disease progresses, inflammatory reactions in the liver can occur. Doctors then speak of steatohepatitis or colloquially of fatty liver hepatitis.

At this stage, there can be a strong increase in connective tissue in the liver. The process is known as liver fibrosis. In the further course there is a threat of increasing scarring of the tissue. In this case, there is so-called cirrhosis of the liver, which is life-threatening as it can lead to liver failure. In addition, the inflammatory processes in the liver promote the development of liver cancer.

Fatty liver can regress

There is currently no drug therapy for fatty liver diseases. The liver, however, has strong regeneration. A change in lifestyle with weight reduction, more exercise, a healthy diet and abstinence from alcohol usually leads to a regression of the fatty liver. For more information, see the article: Fatty Liver: Causes and Therapy. (vb)

Author and source information

This text complies with the requirements of specialist medical literature, medical guidelines and current studies and has been checked by medical professionals.


Diploma-Editor (FH) Volker Blasek


  • Leibniz Institute for Labor Research at TU Dortmund University (IfADo): Fatty liver disease favors the formation of kidney stones (published: 14.09.2021), ifado.de
  • Kathrin Gianmoena, Nina Gasparoni, Cristina Cadenas, et al.: Epigenomic and transcriptional profiling identifies impaired glyoxylate detoxification in NAFLD as a risk factor for hyperoxaluri; in: Cell Reports, 2021, cell.com
  • German Liver Foundation: Fatty liver inflammation (steatohepatitis) – most common liver disease in Germany (accessed: September 15, 2021), deutsche-leberstiftung.de

Important NOTE:
This article is for general guidance only and is not intended to be used for self-diagnosis or self-treatment. He can not substitute a visit at the doctor.



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