MAFLD drives up risk of chronic kidney disease in diabetic individuals

Among adults with type 2 diabetes, the risk of developing chronic kidney disease (CKD) is high in the presence of metabolic dysfunction-associated fatty liver disease (MAFLD), as shown in a study.

The study included a total of 3,627 adults (median age 50.0 years, 68.5 percent men) who had underwent at least three health examinations. CKD was defined as estimated glomerular filtration rate (eGFR) <60 mL/min per 1.73 m² or the occurrence of at least two episodes of proteinuria during the follow-up.

The prevalence rate of MAFLD was 61.6 percent. Over a median follow-up of 10.0 years, CKD occurred in 837 participants (23.1 percent), with the corresponding incidence rate of 244.7 per 10,000 person-years.

Participants with vs without incident CKD tended to be older, either overweight or obese, hypertensive, and have MAFLD. Those in the CKD group also had a higher body mass index, waist circumference, fasting glucose, and creatinine but lower eGFR.

Univariate Cox analysis showed that MAFLD was an important risk factor for incident CKD (hazard ratio [HR], 1.46, 95 percent confidence interval [CI], 1.26-1.70; p<0.001). This association persisted despite adjusting for confounding factors (HR, 1.30, 95 percent CI, 1.11–1.53; p<0.001).

In subgroup analyses, the risk of MAFLD-related CKD was greater among participants no more than 60 years old (HR, 1.58, 95 percent CI, 1.28–1.95; p<0.001) than among those at least 60 years old (HR, 1.03, 95 percent CI, 0.79–1.33; p<0.001).

The present data highlight the potential of early prevention strategies for MAFLD in reducing the incidence of CKD among individuals with type 2 diabetes.