RENAL INJURY AND METABOLIC DYSFUNCTION-ASSOCIATED STEATOTIC LIVER DISEASE IN PATIENTS WITH OBESITY.

Area of Science:

• Nephrology
• Hepatology
• Metabolic Diseases

Background:

• Metabolic dysfunction-associated steatotic liver disease (MASLD) is the leading cause of chronic liver disease globally.
• Emerging evidence links MASLD to kidney injury, influencing patient prognosis.
• This study focuses on the MASLD-renal injury association in individuals with obesity.

Purpose of the Study:

• To investigate the clinical association between MASLD and renal function in patients with obesity class II and III.
• To identify key factors contributing to declining glomerular filtration rate (GFR) in this population.

Main Methods:

• Enrolled patients with obesity (BMI >35 kg/m²) and MASLD.
• Diagnosed MASLD via histology or imaging; assessed liver fibrosis using FIB-4 and NSF scores.
• Calculated GFR using CKD-EPI equation, defining normal GFR as ≥90 and <120 mL/min/1.73 m².

Main Results:

• The study included 560 individuals with obesity and 325 with MASLD (75.4% female, mean age 36±10).
• Hypertension (41.1%) and type 2 diabetes (42.8%) were prevalent.
• 51.1% had GFR <114 mL/min, with 64% of these showing advanced liver fibrosis (FIB-4 >0.54).

Conclusions:

• Age is the primary factor for GFR decline in obese patients with MASLD.
• Glomerular hyperfiltration may signal early chronic kidney disease progression.
• Advancing hepatic fibrosis is a significant contributor to impaired renal function in this cohort.