Metabolic Dysfunction-Associated Steatotic Liver Disease and Chronic Kidney Disease: Unraveling Connections and Advancing Therapies

Metabolic dysfunction-associated steatotic liver disease (MASLD) and chronic kidney disease (CKD) pose substantial global health challenges. The growing concern in the scientific community regarding their association has spurred numerous studies, revealing a robust link in clinical investigations. Despite increasing evidence, the precise mechanistic interplay remains elusive. This review navigates the intricate relationship between MASLD and CKD, spotlighting their worldwide prevalence and shared risk factors. Population-based studies and meta-analyses underscore a significant association, heightening CKD risk in those with MASLD. Pathogenic factors such as lipotoxicity, insulin resistance, oxidative stress, and gut microbiota alterations contribute to both conditions. Acknowledging strengths and limitations of current evidence, the review underscores the necessity for longitudinal studies. Clinical implications encompass early detection, risk stratification, and monitoring, with interventions emphasizing lifestyle modifications and medications targeting shared risk factors. Novel therapies, including melatonin supplementation and modulation of the gut microbiome, are explored. This comprehensive review offers crucial insights into the intertwined nature of MASLD and CKD, guiding clinical practices and shaping future research directions.