Metabolic dysfunction-associated steatotic liver disease (SLD) and alcohol-associated liver disease, but not SLD without metabolic dysfunction, are independently associated with new onset of chronic kidney disease during a 10-year follow-up period

Kazuma Mori; Marenao Tanaka; Tatsuya Sato; Yukinori Akiyama; Keisuke Endo; Toshifumi Ogawa; Toru Suzuki; Hiroki Aida; Wataru Kawaharata; Kei Nakata; Itaru Hosaka; Araya Umetsu; Nagisa Hanawa; Masato Furuhashi

doi:10.1111/hepr.14097

Metabolic dysfunction-associated steatotic liver disease (SLD) and alcohol-associated liver disease, but not SLD without metabolic dysfunction, are independently associated with new onset of chronic kidney disease during a 10-year follow-up period

Hepatol Res. 2024 Aug 7. doi: 10.1111/hepr.14097. Online ahead of print.

Authors

Kazuma Mori^{1

2}, Marenao Tanaka¹, Tatsuya Sato^{1

3}, Yukinori Akiyama⁴, Keisuke Endo¹, Toshifumi Ogawa^{1

3}, Toru Suzuki¹, Hiroki Aida¹, Wataru Kawaharata¹, Kei Nakata¹, Itaru Hosaka⁵, Araya Umetsu⁶, Nagisa Hanawa⁷, Masato Furuhashi¹

Affiliations

¹ Department of Cardiovascular, Renal and Metabolic Medicine, Sapporo Medical University School of Medicine, Sapporo, Japan.
² Department of Immunology and Microbiology, National Defense Medical College, Tokorozawa, Japan.
³ Department of Cellular Physiology and Signal Transduction, Sapporo Medical University School of Medicine, Sapporo, Japan.
⁴ Department of Neurosurgery, Sapporo Medical University School of Medicine, Sapporo, Japan.
⁵ Department of Cardiovascular Surgery, Sapporo Medical University School of Medicine, Sapporo, Japan.
⁶ Department of Ophthalmology, Sapporo Medical University School of Medicine, Sapporo, Japan.
⁷ Department of Health Checkup and Promotion, Keijinkai Maruyama Clinic, Sapporo, Japan.

PMID: 39110552
DOI: 10.1111/hepr.14097

Abstract

Aims: The new nomenclature of steatotic liver disease (SLD) including metabolic dysfunction-associated SLD (MASLD), MASLD and increased alcohol intake (MetALD), and alcohol-associated liver disease (ALD) has recently been proposed. We aimed to elucidate the relationship between each category of SLD and chronic kidney disease (CKD).

Methods: We investigated the effects of various SLDs on the development of CKD, defined as estimated glomerular filtration rate (eGFR) <60 mL/min/1.73 m² or positive for urinary protein, during a 10-year period in 12 138 Japanese subjects (men / women, 7984/4154; mean age, 48 years) who received annual health examinations including abdominal ultrasonography.

Results: The prevalences of SLD without metabolic dysfunction (SLD-MD[-]), MASLD, MetALD, and ALD were 1.7%, 26.3%, 4.9%, and 1.9%, respectively. During the follow-up period, 1963 subjects (16.2%) (men / women, 1374 [17.2%]/589 [14.2%]) had new onset of CKD. Multivariable Cox proportional hazard model analyses after adjustment of age, sex, eGFR, current smoking habit, diabetes mellitus, hypertension, and dyslipidemia showed that the hazard ratios (HR [95% confidence interval]) for the development of CKD in subjects with MASLD (1.20 [1.08-1.33], p = 0.001) and those with ALD (1.41 [1.05-1.88], p = 0.022), but not those with MetALD (1.11 [0.90-1.36], p = 0.332), were significantly higher than the HR in subjects with non-SLD. Interestingly, subjects with SLD-MD[-] had a significantly lower HR (0.61 [0.39-0.96], p = 0.034) than that in subjects with non-SLD. The addition of the novel classification of SLDs into traditional risk factors for the development of CKD significantly improved the discriminatory capacity.

Conclusions: MASLD and ALD, but not SLD-MD[-], are independently associated with the development of CKD.

Keywords: MASLD and increased alcohol intake (MetALD); alcohol‐associated liver disease (ALD); chronic kidney disease (CKD); metabolic dysfunction‐associated steatotic liver disease (MASLD); nonalcoholic fatty liver disease (NAFLD).

Grants and funding

Japan Society for the Promotion of Science