{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,3]],"date-time":"2026-06-03T04:02:58Z","timestamp":1780459378297,"version":"3.54.1"},"reference-count":31,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2026,4,7]],"date-time":"2026-04-07T00:00:00Z","timestamp":1775520000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2026,4,7]],"date-time":"2026-04-07T00:00:00Z","timestamp":1775520000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["dom-pubs.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Diabetes Obesity Metabolism"],"published-print":{"date-parts":[[2026,6]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Aims<\/jats:title>\n                    <jats:p>Although the American Diabetes Association (ADA) recently established a diagnostic algorithm for the early detection of liver fibrosis among high\u2010risk individuals, its implications for chronic kidney disease (CKD) risk stratification remain unclear. We investigated whether the ADA diagnostic algorithm can effectively stratify CKD risk in individuals at risk of cirrhosis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Materials and Methods<\/jats:title>\n                    <jats:p>\n                      This retrospective cohort study included 9264 adults without pre\u2010existing CKD who underwent vibration\u2010controlled transient elastography from April 2006 to October 2018. Participants were categorized into three groups: (1) no metabolic criteria; (2) low\u2010risk (FIB\u20104\u2009&lt;\u20091.3 or 1.3\u20132.67 with liver stiffness [LS]\u2009&lt;\u20098\u2009kPa) and (3) high risk (FIB\u20104\u2009&gt;\u20092.67, or 1.3\u20132.67 with LS \u2265\u20098\u2009kPa). The primary outcome was incident CKD, defined as an estimated glomerular filtration rate (eGFR)\u2009&lt;\u200960\u2009mL\/min\/1.73\u2009m\n                      <jats:sup>2<\/jats:sup>\n                      or proteinuria (\u2265\u20091+) on two consecutive tests. Secondary outcomes included \u2265\u200925% eGFR decline on two visits and 3\u2010 and 5\u2010year risk of CKD.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>During a mean follow\u2010up of 3.7\u2009years, 440 (4.7%) participants developed incident CKD. When stratified by the ADA algorithm, multivariable Cox models revealed a 1.52\u2013fold (95% confidence interval [CI], 1.09\u20132.13) higher risk of incident CKD in the high\u2010risk group than those with no metabolic abnormalities. The high\u2010risk group also had a 2.30\u2013fold higher risk (95% CI, 1.83\u20132.90) of a 25% eGFR decline (mean follow\u2010up 3.5\u2009years) than those with no metabolic abnormalities.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>The two\u2010step ADA algorithm can effectively stratify CKD risk in individuals at high risk of future cirrhosis.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/dom.70730","type":"journal-article","created":{"date-parts":[[2026,4,7]],"date-time":"2026-04-07T07:20:13Z","timestamp":1775546413000},"page":"5240-5251","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Risk Stratification of Chronic Kidney Disease in Adults Using Noninvasive Fibrosis Tests Based on the American Diabetes Association Algorithm"],"prefix":"10.1111","volume":"28","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2893-9576","authenticated-orcid":false,"given":"Chan\u2010Young","family":"Jung","sequence":"first","affiliation":[{"name":"Division of Nephrology, Department of Internal Medicine, Asan Medical Center University of Ulsan College of Medicine  Seoul Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hye Won","family":"Lee","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine Yonsei University, College of Medicine  Seoul Republic of Korea"},{"name":"Department of Internal Medicine Institute of Gastroenterology, Yonsei University  Seoul Republic of Korea"},{"name":"Yonsei Liver Center, Severance Hospital  Seoul Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jung Il","family":"Lee","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine Institute of Gastroenterology, Yonsei University  Seoul Republic of Korea"},{"name":"Department of Internal Medicine Gangnam Severance Hospital  Seoul Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Han Ah","family":"Lee","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine Chung\u2010Ang University College of Medicine  Seoul Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Seung Up","family":"Kim","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine Yonsei University, College of Medicine  Seoul Republic of Korea"},{"name":"Department of Internal Medicine Institute of Gastroenterology, Yonsei University  Seoul Republic of Korea"},{"name":"Yonsei Liver Center, Severance Hospital  Seoul Republic of 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