Abstract: FR-OR002
Metabolic Dysfunction-Associated Steatotic Liver Disease Is Associated with Kidney Dysfunction Independent of Diabetes and Hypertension: A Real-World Cohort Study Using TriNetX
Session Information
- AKI Everywhere All at Once: Risks, Trajectories, and Practice Patterns
November 07, 2025 | Location: Room 320A, Convention Center
Abstract Time: 04:40 PM - 04:50 PM
Category: Acute Kidney Injury
- 101 AKI: Epidemiology, Risk Factors, and Prevention
Authors
- Gerardot, Shori, Medical University of South Carolina, Charleston, South Carolina, United States
- Ibrahim, Ahmed Aa, Medical University of South Carolina, Charleston, South Carolina, United States
- Elbagawy, Mariam Hany, Cairo University Kasr Alainy Faculty of Medicine, Cairo, Cairo Governorate, Egypt
- McMahon, Blaithin A., Medical University of South Carolina, Charleston, South Carolina, United States
Background
Metabolic dysfunction-associated steatotic liver disease (MASLD) is increasingly recognized as a systemic disease. While chronic kidney disease (CKD) is common in MASLD patients, most studies focus on populations with coexisting diabetes and hypertension. We aimed to investigate whether MASLD is an independent risk factor for new renal dysfunction in patients.
Methods
We used TriNetX database to examine adults (≥18 years) diagnosed with MASLD alone (2010-2020). A 1:1 propensity score matching (PSM) was used to compare patients with obesity, BMI ≥25 and MASLD to those without MASLD (control group). Patients with diabetes mellitus, hypertension, viral hepatitis, autoimmune liver disease, alcohol-related liver disease, liver/kidney transplant, acute kidney injury (AKI), CKD or proteinuria were excluded. Patients’ demographics, clinical data, and outcomes were studied using ICD-10-CM codes. The primary outcome was incidence of AKI. Secondary outcomes included new-onset CKD, proteinuria, kidney replacement therapy, and/or major adverse cardiac outcomes. Data was analyzed using TriNetX Analytics built-in functions.
Results
72,922 patients with obesity, BMI ≥25 and MASLD, but without diabetes or hypertension were identified and matched at a 1:1 ratio to the control group. Each group had 72,922 patients and evenly matched clinically (Table 1). Among 72,922 MASLD patients without diabetes or hypertension, 14% developed AKI vs. 7% in the control group. Rates of new proteinuria and CKD were also higher in the MASLD group. MACE was also observed more frequently in the MASLD group compared to the non-MASLD group. However, there were no differences in the incidence of renal dialysis procedures between both groups. Odds ratios and p-values are seen in Table 2.
Conclusion
MASLD is independently associated with an increased risk of renal dysfunction even in the absence of diabetes or hypertension. These findings highlight that routine serum creatinine and urine monitoring in MASLD individuals might be beneficial.