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Optimized Analysis of In Vivo and In Vitro Hepatic Steatosis
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The Metabolic Dysfunction-Associated Steatotic Liver Disease-CKD Axis: Intersecting Pathways and Opportunities for
Sriram Sriperumbuduri1, Prathab Balaji Saravanan2, Gaurav Gupta1
1Division of Nephrology, Virginia Commonwealth University Health System, Richmond, Virginia, USA.
Kidney International Reports
|February 23, 2026
Summary
Chronic kidney disease (CKD) and metabolic dysfunction-associated steatotic liver disease (MASLD) frequently coexist, increasing health risks. Managing metabolic factors is key for early CKD detection in MASLD patients.
Area of Science:
- Nephrology
- Hepatology
- Metabolic Diseases
Background:
- Chronic kidney disease (CKD) and metabolic dysfunction-associated steatotic liver disease (MASLD) are prevalent global health issues.
- MASLD affects nearly one-third of adults and is linked to increased risks of cardiovascular disease, kidney disease, and cancer.
- CKD impacts over 650 million people worldwide, representing a major cause of illness and death.
Purpose of the Study:
- To review epidemiologic and mechanistic evidence linking MASLD and CKD.
- To discuss clinical implications, screening, and management strategies for coexisting MASLD and CKD.
- To highlight the need for multidisciplinary care and further research.
Main Methods:
- Systematic review of epidemiologic and mechanistic studies.
- Synthesis of evidence on shared risk factors and pathophysiologic pathways.
- Analysis of clinical implications for screening and management.
Main Results:
- Studies show a higher prevalence of CKD in patients with MASLD, particularly with advanced liver disease.
- Shared mechanisms include insulin resistance, inflammation, and metabolic factors (obesity, hypertension, diabetes).
- These factors contribute to kidney injury in individuals with MASLD.
Conclusions:
- The overlap between MASLD and CKD necessitates multidisciplinary care approaches.
- Early CKD identification in MASLD patients and aggressive metabolic risk factor management are crucial.
- Further research is needed to optimize screening, understand pathways, and improve treatment.
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