Metabolic associated fatty liver disease is a risk factor for chronic kidney disease

BACKGROUND AND AIMS: To clarify the relationship between metabolic dysfunction‐associated fatty liver disease (MAFLD) and chronic kidney disease (CKD). METHODS: The participants were divided into four groups by the presence or absence of fatty liver disease (FLD) and metabolic dysfunction (MD). MAFLD was defined as having both FLD and MD, whereas CKD was defined as having an estimated glomerular filtration rate of <60 mL/min/1.73 m(2) and/or proteinuria. RESULTS: In this cross‐sectional study of 27,371 participants, the proportions of those in the non‐FLD without MD, non‐FLD with MD, FLD without MD, and MAFLD groups were 48.7, 28.2, 2.3, and 20.8%, respectively. Compared with non‐FLD without MD, MAFLD was associated with the risk of CKD (adjusted odds ratio 1.83 [1.66–2.01], P < 0.001), whereas FLD without MD was not (1.02 [0.79–1.33], P = 0.868). Moreover, compared with FLD without MD, MAFLD was associated with the risk of CKD (1.19 [1.09–1.31], P < 0.001). In this retrospective cohort study, 16,938 of 27,371 participants underwent a median 4.6 (2.0–8.1) years follow‐up, and incident data of non‐FLD without MD, non‐FLD with MD, FLD without MD, and MAFLD were 21.0, 31.1, 26.1, and 31.1 cases per 1,000 person‐years, respectively. Compared with the non‐FLD without MD, MAFLD was associated with the risk of incident CKD (adjusted hazard ratio 1.24 [1.14–1.36], P < 0.001), whereas FLD without MD was not (1.11 [0.85–1.41], P = 0.433). CONCLUSIONS: MAFLD was associated with a risk of CKD, whereas FLD without MD was not a risk for CKD.