Metabolic Dysfunction Is Main Driver of Chronic Kidney Disease Risk

Mendelian randomization analysis revealed no causal effect of steatotic liver disease on CKD risk
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FRIDAY, Feb. 27, 2026 (HealthDay News) -- Metabolic dysfunction, rather than steatotic liver disease (SLD), seems to be the main driver of chronic kidney disease (CKD) risk, according to research published online Feb. 23 in Nutrition & Diabetes.

Xiang Ji, from the Shengjing Hospital of China Medical University in Shenyang, and colleagues updated a meta-analysis on the association between SLD and CKD risk and conducted a two-sample Mendelian randomization (MR) analysis to assess the causal roles of SLD and metabolic factors in CKD. The inverse-variance weighted (IVW) method was used as the primary model for two-sample MR. The meta-analysis included 34 studies with 3,783,136 participants.

The researchers observed significant positive associations for metabolic-associated fatty liver disease, nonalcoholic fatty liver disease, and metabolic dysfunction-associated steatotic liver disease with CKD (hazard ratios, 1.64, 1.43, and 1.34, respectively). In an MR analysis, no causal effect of SLD was seen on the risk for CKD. However, significant associations with increased CKD risk were seen for genetically predicted metabolic factors, including body mass index, waist circumference, type 2 diabetes, systolic and diastolic blood pressure, triglycerides, and high-density lipoprotein cholesterol.

"The association between SLD and CKD likely arises primarily from their shared metabolic risk factors, rather than from a causal relationship between the two conditions," the authors write.

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