The impact of metabolic dysfunction-associated steatotic liver disease (MASH) on the high risk of cardiovascular disease in CKD: interconnections and management

Sep 10, 2025Clinical kidney journal

How fatty liver disease linked to metabolism affects heart disease risk in chronic kidney disease: connections and treatment

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Abstract

Metabolic dysfunction-associated steatotic liver disease () is independently linked to increased cardiovascular and renal risk.

  • MASLD may contribute to systemic metabolic dysfunction and is recognized as a risk enhancer for cardiovascular disease (CVD) and chronic kidney disease ().
  • Key mediators in the relationship between MASLD, CVD, and CKD include insulin resistance, chronic inflammation, and progressive fibrosis.
  • The severity of liver fibrosis in MASLD is associated with worse cardiovascular and renal outcomes.
  • Conventional cardiovascular risk scores might underestimate risk in populations with MASLD and CKD, indicating a need for integrated risk assessment.
  • Current non-invasive diagnostic tools, including fibrosis scores and cardiovascular biomarkers, are available to aid in risk stratification.

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Key numbers

1.45×
Increased Risk
Risk of developing stage 3 or worse in patients.
65% of individuals with diabetes
Prevalence of
Prevalence of among individuals with diabetes.

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