Steatotic liver disease and cardiovascular-kidney-metabolic syndrome

ABSTRACT: Metabolic dysfunction-associated steatotic liver disease (MASLD), formerly known as nonalcoholic fatty liver disease, is the leading cause of chronic liver disease in the world, and is closely linked to metabolic syndrome, and cardiovascular-kidney-metabolic (CKM) syndrome. This article discusses key considerations in diagnosis and management of MASLD, its relevance to CKM syndrome, and associated nursing implications through use of a case example. The article reviews the epidemiology and risk factors of MASLD, summarizes noninvasive diagnostic tools, and discusses lifestyle and pharmacologic treatment options. Incretin therapies, such as glucagon-like peptide-1 (GLP-1) receptor agonists and gastric inhibitory polypeptide/GLP-1 receptor agonists are emphasized, due to their systemic benefits. A simplified screening algorithm using Fibrosis-4 Index and staging criteria for liver fibrosis and CKM syndrome are also provided. Nursing considerations include weight bias awareness, patient-centered communication, interdisciplinary coordination, and the realities of insurance obstacles. Future directions call for system-level efforts to improve equitable access, integrate guideline-based practice, and improve early identification and intervention.