Abstract: SA-PO1090
Trends and Comorbidities of Metabolic Dysfunction-Associated Steatotic Liver Disease Among Kidney Transplant Recipients: A Cross-Sectional Analysis
Session Information
- Transplantation: Clinical - Postkidney Transplant Outcomes and Potpourri
November 08, 2025 | Location: Exhibit Hall, Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Transplantation
- 2102 Transplantation: Clinical
Authors
- Zeleke, Meron B., Virginia Commonwealth University Department of Internal Medicine, Richmond, Virginia, United States
- Gupta, Gaurav, Virginia Commonwealth University Medical Center, Richmond, Virginia, United States
- Paulus, Amber B., Virginia Commonwealth University Department of Internal Medicine, Richmond, Virginia, United States
- Patel, Nilang G., Virginia Commonwealth University Medical Center, Richmond, Virginia, United States
Background
Metabolic Dysfunction-Associated Steatotic Liver Disease (MASLD) affects 32.5% of U.S. adults and may be underrecognized in kidney transplant recipients (KTRs), who face elevated risk due to metabolic complications and immunosuppression. We assess MASLD prevalence in KTRs and identify characteristics linked to increased risk.
Methods
We used TriNetX to identify kidney transplant recipients (≥18 years) and stratified them by MASLD status using ICD-10 codes K76.0 and K75.8. Demographics, comorbidities, medications, and labs were analyzed. The primary outcome was odds of comorbidities by MASLD status. MASLD prevalence trends were also assessed in 2-year intervals starting in 2017.
Results
We identified 138,457 KTRs [mean age 60.3 (15.4) years, 57% male, 50% White] without liver transplant or alcoholic liver disease. Of these, 95.4% had ≥1 cardiometabolic risk factor and 11.8% had all. MASLD was present in 7,164 (5.2%). Compared to those without MASLD, KTRs with MASLD had higher odds of overweight/obesity (OR 4.2), hypertriglyceridemia (OR 3.4), hypertension (OR 3.1), sleep apnea (OR 3.0), diabetes (OR 2.6), hyperlipidemia (OR 2.8), and ischemic heart disease (OR 2.2). They were also more likely to be prescribed statins (72% vs 55%), GLP-1 analogues (21% vs 7%), and insulin (69% vs 51%). Mean ALT and AST were higher in the MASLD group (41.1 vs 32.1 U/L and 52.9 vs 44.7 U/L, respectively). MASLD prevalence increased from 2.57% in 2017–18 to 5.91% in 2023–24 (Figure 1).
Conclusion
The study reveals a high prevalence of MASLD among kidney transplant recipients, with an increasing trend in recent years. This upward trajectory suggests a growing burden of MASLD in the transplant population. KTRs with MASLD are significantly more likely to have metabolic comorbidities, highlighting the need for greater attention to MASLD in post-kidney transplant monitoring and management.