S2672 Association of Kidney Stone Disease With MASLD and MASH: A National Inpatient Sample Study

Introduction: Steatosis of the liver is one of the major components of metabolic syndrome (MetSd). While many studies have identified steatotic liver disease (SLD) as a risk factor for kidney stone disease (KSD), the impact of the severity of steatosis has not been clearly elucidated in the context of other metabolic risk factors for KSD. This cross-sectional population-based study of a large inpatient database sought to investigate the association between KSD and either metabolic dysfunction associated liver disease (MASLD) or metabolic dysfunction associated steatohepatitis (MASH). Methods: We queried the National Inpatient Database between 2016 and 2020 to identify patients with lithiasis as well as patients with MASLD and MASH using ICD10 codes. ICD10 codes were also used to identify other risk factors for stone disease, such as obesity, type II diabetes, gout and smoking. Logistic regression was computed for strength and significance of the relationship between both SLD severity levels and KSD, in univariate and multivariate regression adjusted for age, sex, race, comorbidities burden as well as socio-economic characteristics. All statistical analyses were performed using SAS Enterprise Software 9.4. Results: We initially evaluated the association of SLD with KSD in the general hospitalized population across 5 years. Odds of being a kidney stone former were significantly higher in patients with MASLD and MASH than patients without liver injury. In a subsequent analysis performed in a cohort of hospitalizations that included BMI identifiers, this association of both degrees of SLD with KSD was found to be more pronounced than with diabetes and gout. Finally, comparing both forms of disease severity head-to-head, MASLD was found to have a stronger association with KSD than MASH. Conclusion: Patients with both levels of SLD disease severity were found to have a higher prevalence of KSD. The more pronounced association in milder forms of disease such as MASLD and the lower-than-expected contribution of other conditions involving dysregulation of metabolic homeostasis such as gout or diabetes highlight the central role of SLD in KSD pathogenesis.