Metabolic Burden and Hyperuricemia Are Associated With CKD‐Related Outcomes in Individuals With and Without Steatotic Liver Disease

AIM: Although steatotic liver disease (SLD) has been associated with chronic kidney disease (CKD), it remains unclear whether CKD-related outcomes are driven by hepatic steatosis itself or by accompanying cardiometabolic abnormalities. We investigated the relative contribution of hepatic steatosis and cardiometabolic risk factors to CKD-related outcomes using a large Japanese health screening cohort. METHODS: ) and proteinuria. Multivariable logistic regression and trend analyses were performed to identify factors associated with these outcomes. RESULTS: Compared with non-SLD participants, those with SLD exhibited a higher burden of cardiometabolic abnormalities. Type 2 diabetes mellitus, obesity, and hyperuricemia were independently associated with proteinuria, whereas advanced age (≥ 65 years), low alcohol intake, and hyperuricemia were strongly associated with reduced eGFR. After multivariable adjustment, SLD showed an inverse association with CKD-related outcomes. In both SLD and non-SLD populations, the prevalence of CKD-related outcomes increased stepwise with a higher number of cardiometabolic risk factors. Incorporation of hyperuricemia significantly improved model fit for reduced eGFR (Δ-2 log likelihood = 119.4, p < 0.001) and modestly improved model fit for proteinuria (p = 0.002). CONCLUSIONS: CKD-related outcomes were more strongly associated with the burden of cardiometabolic abnormalities than with hepatic steatosis itself, and these associations were consistent in individuals with and without SLD. Hyperuricemia provided incremental value for renal risk stratification within this cardiometabolic framework, underscoring the importance of comprehensive metabolic risk assessment beyond liver fat status.

Authors

Institutions

Publication Details

Journal
Hepatology Research
Published
2026-08-14
DOI
https://doi.org/10.1111/hepr.70224
Primary Topic
Liver Disease Diagnosis and Treatment
Type
article
Field-Weighted Citation Impact
0.00
Controls
|||
ALL TIME
JAN
FEB
MAR
APR
MAY
JUN
JUL
AUG
SEP
OCT
article

Metabolic Burden and Hyperuricemia Are Associated With CKD‐Related Outcomes in Individuals With and Without Steatotic Liver Disease

Takumi Ohmura, Miwa Kawanaka, Tomoari Kamada, Tsubasa Tsutsumi et al.
Hepatology Research
Liver Disease Diagnosis and Treatment
article

Metabolic Burden and Hyperuricemia Are Associated With CKD‐Related Outcomes in Individuals With and Without Steatotic Liver Disease

Takumi Ohmura, Miwa Kawanaka, Tomoari Kamada, Tsubasa Tsutsumi, Tatsuji Maeshiro, Hitoshi Yoshiji, Michihiro Iwaki, Hayashi Syokita, Hiroshi Sakugawa, Toshio Watanabe, Chitomi Hasebe, Koji Sawada, Kazufumi Okada, Yuichiro Eguchi, Miwa Tatsuta, Takaomi Kessoku, Takemi Akahane, Kanako Fuyama, Yoshioki Yoda, Hiroshi Tobita, Asahiro Morishita, Hirokazu Takahashi, Yuichiro Suzuki, Takumi Kawaguchi, Atsushi Nakajima, Nobuyuki Enomoto, Yoshihiro Kamada, Japan Study Group of Nonalcoholic Fatty Liver Disease (JSG‐NAFLD), Tsutomu Masaki, Yoshio Sumida, Masato Yoneda, Masafumi Ono, Hideki Fujii, Yoichi M. Ito, Naoki Nishimoto
article en

Abstract

AIM: Although steatotic liver disease (SLD) has been associated with chronic kidney disease (CKD), it remains unclear whether CKD-related outcomes are driven by hepatic steatosis itself or by accompanying cardiometabolic abnormalities. We investigated the relative contribution of hepatic steatosis and cardiometabolic risk factors to CKD-related outcomes using a large Japanese health screening cohort. METHODS: ) and proteinuria. Multivariable logistic regression and trend analyses were performed to identify factors associated with these outcomes. RESULTS: Compared with non-SLD participants, those with SLD exhibited a higher burden of cardiometabolic abnormalities. Type 2 diabetes mellitus, obesity, and hyperuricemia were independently associated with proteinuria, whereas advanced age (≥ 65 years), low alcohol intake, and hyperuricemia were strongly associated with reduced eGFR. After multivariable adjustment, SLD showed an inverse association with CKD-related outcomes. In both SLD and non-SLD populations, the prevalence of CKD-related outcomes increased stepwise with a higher number of cardiometabolic risk factors. Incorporation of hyperuricemia significantly improved model fit for reduced eGFR (Δ-2 log likelihood = 119.4, p < 0.001) and modestly improved model fit for proteinuria (p = 0.002). CONCLUSIONS: CKD-related outcomes were more strongly associated with the burden of cardiometabolic abnormalities than with hepatic steatosis itself, and these associations were consistent in individuals with and without SLD. Hyperuricemia provided incremental value for renal risk stratification within this cardiometabolic framework, underscoring the importance of comprehensive metabolic risk assessment beyond liver fat status.

Hepatology Research
Kurume University (JP), Okayama University of Science (JP), Asahikawa Medical University (JP), Okayama University (JP), Saga University (JP), Kawasaki Medical School (JP), Kagawa University (JP), University of the Ryukyus (JP), Yamanashi Research Institute (JP), Okayama University Hospital (JP), University of Yamanashi Hospital (JP), Sapporo Medical University Hospital (JP), Heart Life Hospital (JP), Japanese Red Cross Asahikawa Hospital (JP), Kagawa University Hospital (JP), International University Of Health And Welfare Atami Hospital (JP), Hokkaido University Hospital (JP), Shimane University Hospital (JP), Okinawa Prefecture (JP), Asahikawa Kosei Hospital (JP), Shiga Medical Center (JP), National Hospital Organization Takamatsu Medical Center (JP), Osaka Metropolitan University (JP), Kanagawa Dental University (JP), Nara Medical University (JP), University of Yamanashi (JP), Tokyo Metropolitan University (JP), International University of Health and Welfare (JP), Yokohama City University (JP), The University of Osaka (JP)
Good health and well-being
Openalex Percentile: Top 9%
Liver Disease Diagnosis and Treatment
DOISourceOpenAlex
AI Navigator

Ask Laika to Summarize, Analyze, and Connect papers live on the map.

Summarize Papers & Methodologies

Extract key findings, datasets, and comparative methods across publications.

Benchmark Rankings & Visual Analytics

Rank top research institutions, authors, funders, topics, and journals by Field-Weighted Citation Impact (FWCI) and paper volume with instant charts.

Connect Distant Disciplines

Bridge topological clusters on the map to find hidden collaborative intersections.