Association of metabolic dysfunction-associated fatty liver disease with chronic kidney disease: a Chinese population-based study

BACKGROUND: Metabolic dysfunction-associated fatty liver disease (MAFLD) is a multisystem disorder, but its relationship with kidney injury remains controversial. This study aimed to evaluate MAFLD effects on the chronic kidney disease (CKD) prevalence in a general population in China. METHODS: In total, 15,010 individuals from the Health Management Center of West China Hospital from July 2020 to June 2021 were screened. Hepatic steatosis was defined as a median FibroScan controlled attenuation parameter (CAP)≥240 dB/m using liver ultrasound transient elastography. CKD was defined as an estimated glomerular filtration rate (eGFR) <60 mL/min/1.73 m(2) and/or the presence of albuminuria. The association of MAFLD with CKD was examined using logistic regression. Risk factors for CKD in different MAFLD subgroups were also investigated. RESULTS: A total of 8226 individuals were finally included. Of them, 4406 (53.6%) had MAFLD, and 592 (7.2%) had CKD. After propensity score matching (PSM), 5530 eligible subjects were selected (n = 2765 in each group). There was a higher CKD prevalence in subjects with MAFLD than in those without MAFLD (8.9% vs. 5.4%, p < 0.001). MAFLD was significantly associated with a higher CKD prevalence (OR 1.715, 95% CI 1.389–2.117, p < 0.001), although it was not an independent risk factor. The results indicated that age, diabetes mellitus (DM), overweight/obesity, hypertension, hyperuricemia, hypertriglyceridemia, remnant cholesterol (RC), and C-reactive protein (CRP) were independently associated with a higher CKD prevalence. In the subgroup analysis, hypertension, hyperuricemia, RC, and the nonalcoholic fatty liver disease fibrosis score (NFS) were independent risk factors for the prevalence of CKD in individuals with DM or prediabetes and MAFLD. Furthermore, hypertension, hyperuricemia, and body fat percentage (BFP) were independently associated with CKD in subjects with MAFLD without DM. CONCLUSION: Individuals with MAFLD had a higher prevalence of CKD, whereas it was not an independent risk factor for CKD.