Affiliation:
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
Abstract
AbstractAimsThe 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).MethodsWe 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.ResultsThe 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.ConclusionsMASLD and ALD, but not SLD‐MD[−], are independently associated with the development of CKD.
Funder
Japan Society for the Promotion of Science