Kidney Week

Abstract: SA-PO0517

Time-Dependent Predictive Accuracy of Noninvasive Liver Scores for CKD Onset in Patients with Metabolic Dysfunction-Associated Steatotic Liver Disease: A Longitudinal Cohort Study

Session Information

• CKD: Clinical - Therapies, CKM Health, Special Populations, and More
  October 24, 2026 | Location: Exhibit Hall A, Convention Center
  Abstract Time: 10:00 AM - 12:00 PM

Category: CKD (Non-Dialysis)

• 2202 CKD (Non-Dialysis): Clinical, Outcomes, and Trials

Author

• Trakarnvanich, Thananda, Navamindradhiraj University, Bangkok, Thailand

Thananda Trakarnvanich, MD

Background

Metabolic dysfunction-associated steatotic liver disease (MASLD) significantly increases the risk of developing chronic kidney disease (CKD). While various non-invasive scoring systems are validated for assessing liver fibrosis, their longitudinal performance in predicting time-dependent renal outcomes remains insufficiently characterized.
This study aimed to evaluate and compare the prognostic performance of baseline non-invasive scores in predicting the 5-year incident CKD within a large MASLD cohort.

Methods

This retrospective longitudinal study included 922 patients with MASLD. Baseline estimated glomerular filtration rate (eGFR) was recorded, with annual assessments conducted over a 5-year follow-up period to identify CKD onset (defined as eGFR < 60 mL/min/1.73 m²). The prognostic accuracy of Liver Stiffness Measurement (LSM), Fibrosis-4 (FIB-4) index, NAFLD Fibrosis Score (NFS), and Albumin-Bilirubin (ALBI) score was evaluated using time-dependent Area Under the Receiver Operating Characteristic curve (AUROC) analysis.

Results

Over the 5-year period, 7.16% (n=66) of the cohort developed CKD. Baseline NFS consistently outperformed other modalities in predicting cumulative CKD incidence. NFS demonstrated a robust discriminatory performance with AUROC values ranging from 0.72 to 0.78. In head-to-head comparisons (DeLong test), NFS was significantly superior to both LSM (AUROC 0.63–0.65) and ALBI score (AUROC 0.57–0.60) across all time points (p < 0.05). While NFS trended higher than FIB-4 (AUROC 0.69–0.75), the difference did not reach statistical significance. Using a standard threshold of 1.455, NFS achieved high sensitivity (up to 88.9% at 3 years). Interstingly,the predictive capability of NFS peaked at year 3 before showing a slight progressive decline by years 4 and 5.
In adjusted models, both NFS and FIB-4 remained independent predictors of CKD onset, whereas LSM lost its predictive significance by the end of the follow-up period

Conclusion

NFS is a superior and reliable non-invasive tool compared to LSM, FIB-4, and ALBI for predicting 5-year CKD onset in patients with MASLD. Given its high sensitivity and reliance , baseline NFS assessment can effectively identify high-risk patients, facilitating early nephrological intervention and personalized metabolic management.

Acknowledgment

This work was supported by Division of Gastroenterology and Hepatology, Department of Medicine, Faculty of Medicine Vajira Hospital, Navamindradhiraj University, Bangkok, Thailand

Funding

• Government Support – Non-U.S.