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Updated: Jun 25, 2026

In Vitro Modeling of Fat Deposition in Metabolic Dysfunction-Associated Steatotic Liver Disease
07:03

In Vitro Modeling of Fat Deposition in Metabolic Dysfunction-Associated Steatotic Liver Disease

Published on: July 19, 2024

Risk of CKD in biopsy-proven metabolic dysfunction-associated steatotic liver disease

Fahim Ebrahimi1,2, Christian Eichhorn2,3, Tracey G Simon4

  • 1Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden.

Nephrology, Dialysis, Transplantation : Official Publication of the European Dialysis and Transplant Association - European Renal Association
|June 23, 2026
PubMed
Abstract

Insights

Individuals with metabolic dysfunction-associated steatotic liver disease (MASLD) have a significantly higher risk of developing chronic kidney disease (CKD). This risk increases with the severity of liver disease, underscoring the link between liver and kidney health.

Area of Science:

  • Nephrology
  • Hepatology
  • Epidemiology

Background:

  • Long-term data on chronic kidney disease (CKD) risk in biopsy-proven metabolic dysfunction-associated steatotic liver disease (MASLD) is limited.
  • Metabolic dysfunction-associated steatotic liver disease (MASLD) is increasingly prevalent, raising concerns about associated comorbidities.
  • The relationship between histological severity of MASLD and CKD risk requires further investigation.

Purpose of the Study:

  • To investigate the long-term risk of developing CKD in individuals with biopsy-proven MASLD.
  • To determine if the risk of CKD in MASLD patients varies with the histological severity of the liver disease.
  • To compare CKD risk in MASLD patients to the general population and their siblings.

Main Methods:

  • A nationwide matched cohort study of Swedish adults with histologically confirmed MASLD (1969-2017) was conducted.
  • Patients were categorized by liver histology: simple steatosis, non-fibrotic MASH, non-cirrhotic fibrosis, and cirrhosis.
  • Individuals with MASLD were matched to population comparators and analyzed using multivariable Cox regression, with sibling comparisons also performed.

Main Results:

  • Individuals with MASLD had a 1.85-fold increased hazard of developing the composite CKD outcome compared to controls.
  • The hazard ratio for CKD increased significantly with worsening histological severity of MASLD (Ptrend < 0.001).
  • MASLD patients faced a nearly two-fold increased hazard of CKD and a three-fold increased hazard of kidney failure with replacement therapy (KFRT).

Conclusions:

  • Biopsy-proven MASLD is associated with a significantly higher risk of CKD compared to the general population and siblings.
  • The excess risk of CKD in MASLD is present across all histological stages and escalates with increasing liver disease severity.
  • These findings highlight the critical need for monitoring kidney health in patients diagnosed with MASLD.
Keywords:
CKDMASLDcohortdeathrenal-replacement therapy

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