MAFLD criteria are better than MASLD criteria at predicting the risk of chronic kidney disease

Introduction and Objectives: Fatty liver disease is a multisystem disease. Metabolic dysfunction -associated fatty liver disease (MAFLD) is a more accurate indicator of chronic kidney disease (CKD) than nonalcoholic fatty liver disease (NAFLD). However, the relationship between recently de fined metabolic dysfunction -associated steatotic liver disease (MASLD) and CKD is currently unclear. The objective of this cross-sectional study was to investigate the prevalence of CKD and albuminuria among individuals diagnosed with either MAFLD or MASLD. Patients and Methods: This study involved 5,492 participants who provided biochemical marker and liver ultrasound data from the U.S. National Health and Nutrition Examination Survey (2017 -2020). Multiple logistic regression analyses were conducted to assess the independent associations of nonoverlapping MAFLD and MASLD with the presence of CKD or albuminuria (urinary albumin-to-creatinine ratio >= 3 mg/ mmol). Results: MAFLD and MASLD were identi fied in 47% and 44.5% of the participants, respectively. Individuals with MAFLD-only had a greater prevalence of CKD (24.7% vs. 8.3 %, P < 0.006) and albuminuria (18.6% vs. 5%, P < 0.01) than did those with MASLD-only. Importantly, after adjusting for factors such as sex, age, ethnicity, and alcohol use, it was demonstrated that individuals in the MAFLD-only group had a 4.73 -fold greater likelihood of having prevalent CKD than those in the MASLD-only group ( P < 0.03). Conclusions: The MAFLD criteria better identify patients with CKD than do the MASLD criteria. Therefore, it is suggested that the MASLD criteria be reconsidered, as currently, the justi fication for changing from MAFLD to MASLD criteria may not be appropriate. (c) 2024 Fundaci & oacute;n Cl & iacute;nica M & eacute;dica Sur, A.C. Published by Elsevier Espa & ntilde;a, S.L.U. This is an open access article under the CC BY -NC -ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/)