Metabolic dysfunction-associated fatty liver disease and the risk of incident chronic kidney disease: A 10-year...

To investigate the longitudinal associations of MAFLD with CKD risk.

A total of 10,817 participants derived from the Dongfeng-Tongji (DFTJ) cohort were classified as non-fatty liver disease (non-FLD), non-alcoholic fatty liver disease (NAFLD) without metabolic dysfunction (MD), and MAFLD group. The 8,843 participants had qualitatively controlled genotyping data. An estimated glomerular filtration rate (eGFR) of less than 60 ml/min/1.73 m² was defined as CKD.

Among 10,817 individuals, 1,845 participants developed CKD during ten-year of follow-up. The incidence of CKD was 15.8 %, 10.0 %, and 19.9 % among non-FLD, NAFLD without MD, and MAFLD groups, respectively. Compared with non-FLD participants, the risk of CKD significantly increased in MAFLD group, with the multivariable-adjusted odds ratio (OR) and 95 % confidence interval (CI) of 1.25 (1.11-1.40). Moreover, as the number of MAFLD co-existing metabolic dysfunction components increased, the risk of CKD significantly increased (P-trend < 0.001). MAFLD-related genetic risk score (GRS) was positively associated with elevated blood pressure and elevated triglycerides levels (P < 0.05), which mediated 17.8 % and 14.7 % of the association between MAFLD-related GRS and CKD risk, respectively.

CKD risk was associated with MAFLD presence, and gradually increased with the number of MAFLD metabolic components increased. Metabolic diseases might mediate the association between MAFLD-related GRS and CKD risk.