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Metabolic Dysfunction-Associated Steatotic Liver Disease as a Risk Factor for Chronic Kidney Disease: A Narrative
Marcelo do Rego Maciel Souto Maior1, Nathália de Lacerda Interaminense Ribeiro2, Hannah Vicentini Vitoriano Silva2
1Postgraduate Program in Nutrition, Center for Health Sciences, Federal University of Pernambuco, Recife CEP 50670-901, Brazil.
Biomedicines
|September 27, 2025
Summary
Metabolic dysfunction-associated steatotic liver disease (MASLD) is linked to chronic kidney disease (CKD). Shared risk factors exist, but direct causation is unclear, necessitating further research into MASLD
Area of Science:
- Hepatology and Nephrology
- Metabolic and Endocrine Disorders
Background:
- Metabolic dysfunction-associated steatotic liver disease (MASLD), formerly NAFLD, is the most prevalent chronic liver disease globally.
- MASLD is independently associated with extrahepatic conditions like chronic kidney disease (CKD), with severe forms posing higher risks.
- Shared cardiometabolic risk factors (obesity, hypertension, diabetes) complicate establishing a direct causal link between MASLD and CKD.
Purpose of the Study:
- To review shared risk factors between MASLD and CKD.
- To explore potential direct pathogenic mechanisms of MASLD on kidney health.
- To identify literature gaps and suggest future research directions.
Main Methods:
- Literature review and synthesis of observational studies.
- Analysis of shared risk factors and potential pathophysiological pathways.
- Identification of research gaps concerning nomenclature, pediatric populations, MetALD, and co-therapeutics.
Main Results:
- MASLD and CKD share numerous cardiometabolic risk factors, making direct causality difficult to prove.
- Potential MASLD-driven mechanisms include endocrine, hemodynamic, immune, and oxidative stress pathways.
- Significant gaps exist in understanding MASLD's impact on CKD, especially in specific populations and combined alcohol-intake scenarios.
Conclusions:
- MASLD is strongly associated with CKD, but definitive causal evidence is limited by confounding factors and study heterogeneity.
- Further research is crucial to elucidate direct pathogenic links and inform integrated management strategies.
- Addressing research gaps is essential for preventing or mitigating kidney dysfunction in MASLD patients.
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