Metabolic dysfunction-associated fatty liver disease an independent predictor of CKD: Study

Chronic kidney disease (CKD) is a global health challenge that can progress to end-stage renal disease (ESRD). ESRD needs renal replacement therapy or transplantation but has high morbidity, mortality, and financial burden. Non-alcoholic fatty liver disease (NAFLD) can increase the risk of CKD. NAFLD has recently been renamed metabolic dysfunction-associated fatty liver disease (MAFLD). As there is ambiguity on the association between MAFLD and chronic kidney disease (CKD), researchers conducted a meta-analysis of cohort studies to explore the CKD risk in MAFLD patients.

Databases like PubMed, CENTRAL, Embase, Scopus, and Web of Science were searched from the earliest possible date to 17th May 2024 for cohort studies examining the link between MAFLD and CKD. All the retrospective or prospective cohort studies conducted on the adult population with exposure to MAFLD and outcomes as CKD on follow-up were included. Information on author name, year of publication, database, location, study design, population included, sample size, age and gender, diagnosis of MAFLD & CKD, incidence of CKD, CKD risk factors, covariates adjusted, follow-up, and outcome were collected by the authors. The Newcastle-Ottawa Scale (NOS) was used to evaluate the risk of bias.

Findings:

• Eight studies with nine cohorts were included.
• MAFLD was found to be an independent risk factor as per the Pooled analysis of all nine cohorts.
• Sensitivity analysis did not reveal any change in the results.
• There was no significant difference in effect size on subgroup analysis based on study design (prospective or retrospective), country of origin (China, Korea, Japan, or UK), the incidence of CKD in the cohort (> 10% or ≤ 10%) and if the study adjusted for cardiovascular disease, diabetes, hypertension, and smoking status.
• Meta-analysis revealed that MAFLD was still a risk factor for CKD in men, women, overweight and non-overweight cohorts.

Thus, the study concluded that MAFLD is a significant and independent risk factor for CKD irrespective of sex, body mass index, and other risk factors. However, researchers suggested that further studies should be conducted to explore the association between the severity of MAFLD and CKD. MAFLD patients must be closely monitored and regularly counseled for the development of CKD.

Further reading: Liu, W., Sun, X. Does metabolic dysfunction-associated fatty liver disease increase the risk of chronic kidney disease? A meta-analysis of cohort studies. BMC Nephrol 25, 467 (2024). https://doi.org/10.1186/s12882-024-03910-6.