Acute kidney injury is associated with liver-related events in patients with metabolic dysfunction-associated fatty liver disease - 24/03/25
, Sheng Nie a, ⁎ Highlights |
• | With the increasing prevalence of metabolic disorders, the incidence of MAFLD is rising rapidly. |
• | AKI was associated with an increased risk of composite liver outcomes and hepatic fibrosis progression among patients with MAFLD. |
• | Renohepatic crosstalk and metabolic factors may provide insights into the potential relationship between MAFLD and AKI. |
• | It is crucial to early identify and manage AKI in MAFLD population, and utilize FIB-4 scores in risk stratification. |
Abstract |
Background |
Evidence regarding the role of acute kidney injury (AKI) in long-term development of metabolic dysfunction-associated fatty liver disease (MAFLD) is limited. We aimed to investigate the associations between AKI and liver-related events in patients with MAFLD.
Methods |
This study involved 50,499 Chinese adults with MAFLD from the China Renal Data System (CRDS) database. We identified AKI using patient-level serum creatinine data according to the Kidney Disease Improving Global Outcomes (KDIGO) criteria. The primary outcome was a composite of liver-related mortality and major adverse liver outcomes. The secondary outcome was an escalation of fibrosis-4 (FIB-4) risk scores. Cox proportional hazard models were performed to assess the association between AKI and the study outcomes.
Results |
The median age of the patients was 59.17 years, with 54.7% being male. There were 3,711 (7.3%) patients who experienced AKI during hospitalization. A total of 1,660 (3.3%) patients experienced composite liver outcome. Patients with AKI during hospitalization had higher risk of composite liver outcomes (adjusted hazard ratio (aHR) 1.83 [95% confidence interval 1.38;2.41] P < 0.001), especially among those with severe AKI (stage 2/3) (aHR 2.36 [1.57;3.54] P < 0.001). Regarding the secondary outcome, AKI was also associated with an increased risk of escalation of FIB-4 risk scores (aHR 1.28 [1.14;1.44] P < 0.001). These associations remained consistent across various subgroups and sensitivity analyses.
Conclusions |
AKI was significantly associated with an increased risk of liver-related events among patients with MAFLD. These findings suggest that enhanced vigilance toward AKI may be justifiable in MAFLD patients.
Le texte complet de cet article est disponible en PDF.Keywords : Acute kidney injury, Composite liver outcomes, Fibrosis-4, Metabolic dysfunction-associated fatty liver disease, Renohepatic crosstalk
Abbreviations : AKI, MAFLD, CRDS, KDIGO, FIB-4, aHR, CI, NAFLD, HCC, ICD-10, eGFR, SCr, CDC, ALT, AST, CKD, HBV, CCI, ALB, ALP, LDL, Tbil, AFP, RASi, IQR, HR, cHR
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Vol 51 - N° 3
Article 101639- mai 2025 Retour au numéro
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