Metabolic dysfunction-associated fatty liver disease can significantly increase the risk of chronic kidney disease in adults with type 2 diabetes

Aims: This study is to explore the relationship between metabolic dysfunction-associated fatty liver disease (MAFLD) and chronic kidney disease (CKD) among populations with type 2 diabetes through longitudinal cohort study.Methods: 3,627 subjects who had received at least three health examinations between 2008 and 2015 were included. CKD was stated as subjects with an eGFR < 60 mL/min per 1.73 m2 or the occurrence of 2 or more proteinuria during their follow-up.Results: After median of 10.0 years follow up, 837 (23.1%) developed CKD (244.7 per 10,000 person-years; 95 % CI, 228.4 - 261.8). MAFLD ([HR] 1.46; 95 % CI 1.26-1.70, P < 0.001) acts as an important risk factor of developing CKD. After adjusting for confounding factors, this association was consistent (HR 1.30; 95 % CI 1.111.53, P < 0.001). In stratified analysis, subjects aged < 60 years were likely to have greater risk of MAFLDrelated CKD (HR 1.58 and 1.03; 95 % CI 1.28-1.95 and 0.79-1.33, P < 0.001 in both cases, respectively). Conclusions: The risk of developing CKD in type 2 diabetes adults with MAFLD was higher, especially if they are below 60 years old. This study underscores the importance of early prevention strategies for MAFLD to reduce the occurrence of CKD in type 2 diabetes adults.