An international Delphi consensus statement on metabolic dysfunction-associated fatty liver disease and risk of chronic kidney disease

Abstract

Background: With the rising global prevalence of fatty liver disease related to metabolic dysfunction, the association of this common liver condition with chronic kidney disease (CKD) has become increasingly evident. In 2020, the more inclusive term metabolic dysfunction-associated fatty liver disease (MAFLD) was proposed to replace the term non-alcoholic fatty liver disease (NAFLD). The observed association between MAFLD and CKD and our understanding that CKD can be a consequence of underlying metabolic dysfunction support the notion that individuals with MAFLD are at higher risk of having and developing CKD compared with those without MAFLD. However, to date, there is no appropriate guidance on CKD in individuals with MAFLD. Furthermore, there has been little attention paid to the link between MAFLD and CKD in the Nephrology community.Methods and Results: Using a Delphi-based approach, a multidisciplinary panel of 50 international experts from 26 countries reached a consensus on some of the open research questions regarding the link between MAFLD and CKD.Conclusions: This Delphi-based consensus statement provided guidance on the epidemiology, mechanisms, management and treatment of MAFLD and CKD, as well as the relationship between the severity of MAFLD and risk of CKD, which establish a framework for the early prevention and management of these two common and interconnected diseases.

Hepatocytic ballooning in non‐alcoholic steatohepatitis: Dilemmas and future directions

“…Hepatocytic ballooning has been associated with greater severity of liver disease and higher risk of developing liver‐related complications, cardiovascular disease and chronic kidney disease 1,2 . Matteoni et al 3 reported that liver‐related deaths occurred more frequently in patients in whom liver biopsies showed hepatocytic ballooning, Mallory‐Denk bodies (MDBs) or fibrosis.…”

Adverse effect of PNPLA3 p.I148M genetic variant on kidney function in middle‐aged individuals with metabolic dysfunction

“…10,18 These findings are also in line with a Delphi-based consensus statement reached from a multidisciplinary panel of international experts, supporting the existence of a significant association between PNPLA3 p.I148M variant and risk of kidney dysfunction. 19 To our knowledge, there is currently little information about the association between the PNPLA3 p.I148M variant and decreasing levels of eGFR, even within the normal range, in individuals with metabolic dysfunction and without advanced kidney disease.…”

Norcholic acid: a novel biomarker of early kidney injury in patients with metabolic dysfunction-associated fatty liver disease

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