The Role of Metabolic Dysfunction-Associated Fatty Liver Disease in Developing Chronic Kidney Disease: Longitudinal Cohort Study

JMIR Public Health Surveill. 2023 May 4:9:e45050. doi: 10.2196/45050.

Abstract

Background: The association between metabolic dysfunction-associated fatty liver disease (MAFLD) and chronic kidney disease (CKD) is unclear.

Objective: This longitudinal cohort study aimed to test whether MAFLD plays an important role in the development of CKD.

Methods: This cohort study included 41,246 participants who had undergone 3 or more health examinations from 2008 to 2015 at the People's Hospital of Guangxi Zhuang Autonomous Region, China. Participants were categorized into 2 groups according to whether they presented with or without MAFLD. The occurrence of new-onset CKD was stated as either an estimated glomerular filtration rate of <60 mL/min per 1.73 m2 or a higher level of albuminuria during their follow-up appointment. The association between MAFLD and CKD was evaluated using a Cox regression method.

Results: Of the 41,246 participants, 11,860 (28.8%) were diagnosed with MAFLD. Over the course of the 14-year follow-up (median 10.0 years), 5347 (13%) participants experienced a new incident of CKD (135.73 per 10,000 person-years). MAFLD was discovered as an important risk factor for new incidents of CKD (hazard ratio 1.18, 95% CI 1.11-1.26) by using the multivariable Cox proportional hazard regression model. When stratified by gender, the adjusted hazard ratio for the incidence of CKD in men and women with MAFLD were 1.16 (95% CI 1.07-1.26) and 1.32 (95% CI 1.18-1.48), respectively. According to the subgroup analysis results, after adjusting for confounding factors, the MAFLD-related CKD risk was greater in men aged <60 years (Pinteraction=.001) and in those with combined dyslipidemia (Pinteraction=.02), but this relationship was not found in women (all Pinteraction>.05).

Conclusions: MAFLD plays an important role in the development of new incidents of CKD in the long run.

Trial registration: Chinese Clinical Trial Registry ChiCTR2200058543; https://www.chictr.org.cn/showproj.html?proj=153109.

Keywords: MAFLD; association; chronic disease; chronic kidney disease; cohort study; incidence; incidence rate; kidney; liver; metabolic dysfunction–associated fatty liver disease; prevalence; renal; risk factor.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • China / epidemiology
  • Cohort Studies
  • Female
  • Humans
  • Longitudinal Studies
  • Male
  • Non-alcoholic Fatty Liver Disease* / complications
  • Non-alcoholic Fatty Liver Disease* / epidemiology
  • Renal Insufficiency, Chronic* / complications
  • Renal Insufficiency, Chronic* / diagnosis
  • Renal Insufficiency, Chronic* / epidemiology

Associated data

  • ChiCTR/ChiCTR2200058543