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An international Delphi consensus statement on metabolic dysfunction-associated fatty liver disease and risk of chronic kidney disease

Sun DQ 1 , Targher G 2 , Byrne CD 3 , Wheeler DC 4 , Wong VW 5 , Fan JG 6 Show all authors , Tilg H 7 , Yuan WJ 8 , Wanner C 9 , Gao X 10 , Long MT 11 , Kanbay M 12 , Nguyen MH 13 , Navaneethan SD 14 , Yilmaz Y 15 , Huang Y 16 , Gani RA 17 , Marzuillo P 18 , Boursier J 19 , Zhang H 20 , Jung CY 21 , Chai J 22 , Valenti L 23 , Papatheodoridis G 24 , Musso G 25 , Wong YJ 26 , El-Kassas M 27 , Méndez-Sánchez N 28 , Sookoian S 29 , Pavlides M 30 , Duseja A 31 , Holleboom AG 32 , Shi J 33 , Chan WK 34 , Fouad Y 35 , Yang J 36 , Treeprasertsuk S 37 , Cortez-Pinto H 38 , Hamaguchi M 39 , Romero-Gomez M 40 , Al Mahtab M 41 , Ocama P 42 , Nakajima A 43 , Dai C 36 , Eslam M 44 , Wei L 45 , George J 44 , Zheng MH 46

Affiliations 

  • 1 Department of Nephrology, Jiangnan University Medical Center, Wuxi, China
  • 2 Section of Endocrinology, Diabetes and Metabolism, Department of Medicine, Azienda Ospedaliera Universitaria Integrata Verona, Verona, Italy
  • 3 Southampton National Institute for Health and Care Research Biomedical Research Centre, University Hospital Southampton, and Southampton General Hospital, University of Southampton, Southampton, UK
  • 4 Department of Renal Medicine, University College London, London, UK
  • 5 Department of Medicine and Therapeutics, Chinese University of Hong Kong, Hong Kong, China
  • 6 Center for Fatty Liver, Department of Gastroenterology, Xin Hua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
  • 7 Department of Internal Medicine I, Gastroenterology, Endocrinology & Metabolism, Medical University Innsbruck, Innsbruck, Austria
  • 8 Department of Nephrology, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
  • 9 Division of Nephrology, Department of Medicine, Würzburg University Clinic, Würzburg, Germany
  • 10 Department of Endocrinology and Metabolism, Zhongshan Hospital, Fudan University, Shanghai, China
  • 11 Section of Gastroenterology, Boston Medical Center, Boston University School of Medicine, Boston, MA, USA
  • 12 Division of Nephrology, Department of Medicine (M.K.), Koc University School of Medicine, Istanbul, Turkey
  • 13 Division of Gastroenterology and Hepatology, Department of Medicine, Stanford University Medical Center, Palo Alto, CA, USA
  • 14 Section of Nephrology and Institute of Clinical and Translational Research, Baylor College of Medicine, and Michael E. DeBakey VA Medical Center, Houston, TX, USA
  • 15 Department of Gastroenterology, School of Medicine, Marmara University, Istanbul, Turkey
  • 16 Department of Cardiology, Shunde Hospital, Southern Medical University, Foshan, China
  • 17 Division of Hepatobiliary, Department of Internal Medicine, Dr. Cipto Mangunkusumo National General Hospital, Medical Faculty Universitas Indonesia, Jakarta, Indonesia
  • 18 Department of Woman, Child and of General and Specialized Surgery, Università della Campania "Luigi Vanvitelli", Napoli, Italy
  • 19 HIFIH Laboratory, UPRES EA3859, Angers University, Angers, France
  • 20 Department of Endocrinology and Metabolism, Nanfang Hospital, Southern Medical University, Guangzhou, China
  • 21 Department of Internal Medicine, College of Medicine, Yonsei University, Seoul, Republic of Korea
  • 22 Cholestatic Liver Diseases Center, Department of Gastroenterology, Southwest Hospital, Third Military Medical University (Army Medical University), Chongqing, China
  • 23 Department of Pathophysiology and Transplantation, Fondazione IRCCS Ca' Granda Ospedale Policlinico Milano, Università degli Studi di Milano, Milan, Italy
  • 24 Department of Gastroenterology, Laiko General Hospital, Medical School of National and Kapodistrian University of Athens, Athens, Greece
  • 25 Emergency and Intensive Care Medicine, HUMANITAS Gradenigo Hospital
  • 26 Department of Gastroenterology & Hepatology, Changi General Hospital, Singhealth, Singapore, Singapore
  • 27 Department of Endemic Medicine, Faculty of Medicine, Helwan University, Cairo, Egypt
  • 28 Liver Research Unit, Medica Sur Clinic & Foundation, Mexico City, Mexico
  • 29 Clinical and Molecular Hepatology, Centro de Altos Estudios en Ciencias Humanas y de la Salud (CAECIHS), Universidad Abierta Interamericana, Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET), Buenos Aires, Argentina
  • 30 Oxford NIHR Biomedical Research Centre, University of Oxford, Oxford, UK
  • 31 Department of Hepatology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
  • 32 Department of Vascular Medicine, Amsterdam University Medical Centers, Amsterdam, The Netherlands
  • 33 Department of Hepatology, The Affiliated Hospital of Hangzhou Normal University, Hangzhou, China
  • 34 Department of Medicine, University of Malaya, Kuala Lumpur, Malaysia
  • 35 Department of Gastroenterology, Hepatology and Endemic Medicine, Faculty of Medicine, Minia University, Minya, Egypt
  • 36 Center for Kidney Disease, The Second Affiliated Hospital, Nanjing Medical University, Nanjing, China
  • 37 Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
  • 38 Clínica Universitária de Gastrenterologia, Laboratório de Nutrição, Faculdade de Medicina, Universidade de Lisboa, Lisboa, Portugal
  • 39 Department of Endocrinology and Metabolism, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan
  • 40 UCM Digestive Diseases, University Hospital Virgen del Rocio, Institute of Biomedicine of Seville (CSIC/HUVR/US), Ciberehd, University of Seville, Sevilla, Spain
  • 41 Department of Hepatology, Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh
  • 42 Department of Medicine, Makerere University of College of Health Sciences, Kampala, Uganda
  • 43 Department of Gastroenterology and Hepatology, Yokohama City University Graduate School of Medicine, Yokohama, Japan
  • 44 Storr Liver Centre, Westmead Institute for Medical Research, Westmead Hospital and University of Sydney, Sydney, NSW, Australia
  • 45 Hepatopancreatobiliary Center, Beijing Tsinghua Changgung Hospital, Tsinghua University, Beijing, China
  • 46 MAFLD Research Center, Department of Hepatology, the First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
Hepatobiliary Surg Nutr, 2023 Jun 01;12(3):386-403.
PMID: 37351121 DOI: 10.21037/hbsn-22-421

Abstract

BACKGROUND: With the rising global prevalence of fatty liver disease related to metabolic dysfunction, the association of this common liver condition with chronic kidney disease (CKD) has become increasingly evident. In 2020, the more inclusive term metabolic dysfunction-associated fatty liver disease (MAFLD) was proposed to replace the term non-alcoholic fatty liver disease (NAFLD). The observed association between MAFLD and CKD and our understanding that CKD can be a consequence of underlying metabolic dysfunction support the notion that individuals with MAFLD are at higher risk of having and developing CKD compared with those without MAFLD. However, to date, there is no appropriate guidance on CKD in individuals with MAFLD. Furthermore, there has been little attention paid to the link between MAFLD and CKD in the Nephrology community.

METHODS AND RESULTS: Using a Delphi-based approach, a multidisciplinary panel of 50 international experts from 26 countries reached a consensus on some of the open research questions regarding the link between MAFLD and CKD.

CONCLUSIONS: This Delphi-based consensus statement provided guidance on the epidemiology, mechanisms, management and treatment of MAFLD and CKD, as well as the relationship between the severity of MAFLD and risk of CKD, which establish a framework for the early prevention and management of these two common and interconnected diseases.

* Title and MeSH Headings from MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine.

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