Diabetes & metabolismDec 23, 2023

Fatty Liver Disease and Its Link to Long-Term Kidney Disease Risk

GLP-1 Therapies Weekly Brief ↗PubMed ↗DOI ↗

Updated Mar 22, 2026

Abstract

The change from non-alcoholic fatty liver disease (NAFLD) to metabolic dysfunction-associated steatotic liver disease (MASLD) reflects a significant shift in understanding a common liver condition.

The term MAFLD was proposed in 2020 to better encompass metabolic dysfunction-related fatty liver disease.
In 2023, a consensus established that diagnosis of MASLD requires the presence of at least one of five common cardiometabolic risk factors.
There is an observed association between MASLD and an increased risk of developing chronic kidney disease (CKD).
CKD may be linked to underlying metabolic dysfunction in individuals with MASLD.
This review discusses the evolution of diagnostic criteria, epidemiological links between MASLD and CKD, mechanisms of increased CKD risk, and potential drug treatments.

Simplified

With the rising tide of fatty liver disease related to metabolic dysfunction worldwide, the association of this common liver disease 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 old term non-alcoholic fatty liver disease (NAFLD). In 2023, a modified Delphi process was led by three large pan-national liver associations. There was consensus to change the fatty liver disease nomenclature and definition to include the presence of at least one of five common cardiometabolic risk factors as diagnostic criteria. The name chosen to replace NAFLD was metabolic dysfunction-associated steatotic liver disease (MASLD). The change of nomenclature from NAFLD to MAFLD and then MASLD has resulted in a reappraisal of the epidemiological trends and associations with the risk of developing CKD. The observed association between MAFLD/MASLD and CKD and our understanding that CKD can be an epiphenomenon linked to underlying metabolic dysfunction support the notion that individuals with MASLD are at substantially higher risk of incident CKD than those without MASLD. This narrative review provides an overview of the literature on (a) the evolution of criteria for diagnosing this highly prevalent metabolic liver disease, (b) the epidemiological evidence linking MASLD to the risk of CKD, (c) the underlying mechanisms by which MASLD (and factors strongly linked with MASLD) may increase the risk of developing CKD, and (d) the potential drug treatments that may benefit both MASLD and CKD.

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Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.

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Fatty Liver Disease and Its Link to Long-Term Kidney Disease Risk

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