Adherence to healthy lifestyle was associated with an attenuation of the risk of chronic kidney disease from metabolic dysfunction-associated fatty liver disease: Results from two prospective cohorts

Disease areas:

gut health
reproductive and urinary health

Last updated:: 2 July 2025

Author(s):: Yixiao Zhang, Tingjing Zhang, Yashu Liu, Song Bai, Jinguo Jiang, Hua Zhou, Junjun Luan, Limin Cao, Yanling Lv, Qing Zhang, Li Liu, Shaomei Sun, Xing Wang, Ming Zhou, Qiyu Jia, Kun Song, Hehua Zhang, Qing Chang, Xiude Fan, Yang Ding, Liangkai Chen, Yuhong Zhao, Kaijun Niu, Yang Xia
Publish date:: 2 October 2023
Journal:: Diabetes & Metabolic Syndrome Clinical Research & Reviews
PubMed ID:: 37804689
DOI:: 10.1016/j.dsx.2023.102873

Abstract

AIMS: Non-alcoholic fatty liver disease (NAFLD) and metabolic dysfunction-associated fatty liver disease (MAFLD) are important risk factors of chronic kidney disease (CKD). Whether adherence to a healthy lifestyle can modify these effects remain unknown. This study aimed to evaluate the modification effects of healthy lifestyle on the associations among NAFLD, MAFLD, and the risk of CKD, with taking into the effect of genetic risk.

METHODS: The Tianjin Chronic Low-grade Systemic Inflammation and Health Cohort Study (TCLSIH), the UK Biobank Study (UKB). The outcome was incident CKD. The exposures including NAFLD, MAFLD, healthy lifestyle, and a genetic risk score (GRS) for CKD.

RESULTS: After 1,135,334 person-year follow-up, we documented 2975 incident CKD cases in the two cohorts. MAFLD and NAFLD were associated with a higher risk of CKD, particularly in patients with MAFLD. In the TCLSIH and UKB, the hazard ratios (95% confidence intervals) of incident CKD for MAFLD were 1.47 (1.30, 1.66) and 1.73 (1.57, 1.91), respectively. Adherence to a healthier lifestyle decreased the risk of CKD from MAFLD with significant interaction effects (TCLSIH: P_interaction = 0.02; UKB: P_interaction = 0.04). Participants with a lower CKD-GRS experienced a higher risk of CKD from MAFLD, but achieved two healthy lifestyles can significantly decreased the risk of CKD in patients with MAFLD.

CONCLUSIONS: MAFLD and NAFLD are associated with a higher CKD risk, particularly MAFLD. Adherence to a healthier lifestyle was associated with a lower risk of CKD from MAFLD. These results highlight the important role of following a healthy lifestyle to prevent CKD.