1.Co-management of the liver and the kidney: New prospects in the clinical management of metabolic dysfunction-associated fatty liver disease with chronic kidney disease
Qiongyue FAN ; Danqin SUN ; Chunsun DAI ; Minghua ZHENG
Journal of Clinical Hepatology 2025;41(9):1744-1751
This article investigates the collaborative management of metabolic dysfunction-associated fatty liver disease (MAFLD) and chronic kidney disease (CKD). As major public health issues worldwide, MAFLD and CKD are closely related in terms of epidemiology, pathogenesis, and management strategies, and however, there are still many challenges in the multidisciplinary collaborative management of the two diseases. This article systematically elaborates on the epidemiology of MAFLD and CKD, summarizes their common risk factors such as metabolic disorder, genetic susceptibility, and active metabolites, and reviews the mutual screening strategies and combined management models based on noninvasive imaging, serum markers, FIB-4 score, and liver stiffness measurement. In addition, this article summarizes the advances in the application of lifestyle intervention and new drugs (such as GLP-1 receptor agonists and SGLT-2 inhibitors) and emphasizes the importance of multidisciplinary collaboration in improving the prognosis of patients. Due to the close association between MAFLD and CKD, their joint management is crucial, and therefore, it is necessary to establish a multidisciplinary collaboration mechanism and implement the measures of precise screening, comprehensive treatment, and long-term monitoring, so as to improve the prognosis of patients and reduce the risk of complications. Finally, this article proposes that in the future, more effective combined treatment regimens should be explored to expand the clinical options for the co-management of the liver and the kidney.
2.An excerpt of an international Delphi consensus statement on metabolic dysfunction-associated fatty liver disease and risk of chronic kidney disease (2023)
Danqin SUN ; Jiaqi SHEN ; Minghua ZHENG
Journal of Clinical Hepatology 2024;40(1):42-45
In 2020, an international expert panel proposed to replace nonalcoholic fatty liver disease with metabolic associated fatty liver disease (MAFLD). Recent studies have shown that there is a higher risk of chronic kidney disease (CKD) in the MAFLD population and that MAFLD is an independent risk factor for CKD. However, up to now, there are still no guidelines on the prevention and treatment of MAFLD-related CKD. Based on the Delphi method, the authors led a multidisciplinary team of 50 authoritative experts from 26 countries to reach a consensus on some open-ended research issues about the association between MAFLD and CKD, which can help to clarify the important clinical association between MAFLD and the risk of CKD and improve the understanding of the epidemiology, pathogenesis, management, and treatment of MAFLD and CKD, so as to establish a framework for the early prevention and management of these two common and interrelated diseases.

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