{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,21]],"date-time":"2026-10-21T19:57:48Z","timestamp":1792612668948,"version":"4.5.0"},"reference-count":69,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"19","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2025,10,7]]},"abstract":"<jats:sec xml:lang=\"en\">\n                    <jats:title>Background<\/jats:title>\n                    <jats:p xml:lang=\"en\">Metabolic dysfunction\u2010associated steatotic liver disease (MASLD) and chronic kidney disease (CKD) are important cardiovascular risk factors. However, the prognostic impact of coexisting MASLD and CKD remains understudied.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p xml:lang=\"en\">This study cohort used the NHANES (National Health and Nutrition Examination Survey) 2007 to 2018 database, examining outcomes in adults with varying MASLD and CKD statuses. The primary outcome was all\u2010cause mortality. Secondary outcomes included coronary heart disease, heart failure, stroke, and cancer. Cox regression model was constructed to investigate the relationship between MASLD\/CKD and all\u2010cause mortality, adjusted for age, prior coronary heart disease, body mass index, smoking, poverty\u2010to\u2010income ratio, lipid\u2010lowering\u00a0and glucose\u2010lowering medications. Sensitivity analysis was performed with hepatic fibrosis and CKD.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Results<\/jats:title>\n                    <jats:p xml:lang=\"en\">\n                      Among 14\u2009818 participants (mean follow\u2010up: 6.9\u2009\u00b1\u20093.4\u2009years), a majority of participants had MASLD(\u2212)\/CKD(\u2212) (50.8%), followed by MASLD(+)\/CKD(\u2212) (34.8%), MASLD(+)\/CKD(+) (7.7%), and MASLD(\u2212)\/CKD(+) (6.7%). MASLD(+)\/CKD(+) (n\u2009=\u20091142) had the highest rates of obesity (77.6%), hypertension (77.5%), dyslipidemia (67.0%), and diabetes (49.7%), with the highest risk of coronary heart disease (risk ratio [RR], 1.79 [95% CI, 1.13\u20132.82],\n                      <jats:italic toggle=\"no\">P<\/jats:italic>\n                      \u2009=\u20090.013) and heart failure (RR 2.33 [95% CI, 1.07\u20135.08],\n                      <jats:italic toggle=\"no\">P<\/jats:italic>\n                      \u2009=\u20090.033). Socioeconomic disparities were observed, with lower\u2010income individuals predominantly in the group with MASLD(+)\/CKD(+) (\n                      <jats:italic toggle=\"no\">P<\/jats:italic>\n                      \u2009&lt;\u20090.001). MASLD(+)\/CKD(+) (adjusted hazard ratio [aHR], 3.28 [95% CI, 1.89\u20135.70],\n                      <jats:italic toggle=\"no\">P<\/jats:italic>\n                      \u2009&lt;\u20090.001) and MASLD(\u2212)\/CKD(+) (aHR, 2.18 [95% CI, 1.33\u20133.66],\n                      <jats:italic toggle=\"no\">P<\/jats:italic>\n                      \u2009=\u20090.002) phenotypes were independent mortality predictors. Although MASLD(\u2212)\/CKD(+) and MASLD(+)\/CKD(+) had unfavorable 10\u2010year prognoses, survival was worse in those with both hepatic fibrosis and CKD (\n                      <jats:italic toggle=\"no\">P<\/jats:italic>\n                      \u2009&lt;\u20090.001).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p xml:lang=\"en\">MASLD(+)\/CKD(+) phenotype increases the risk of cardiometabolic multimorbidity and independently predicts mortality. Mortality risk increased progressively in individuals with both advanced hepatic fibrosis and CKD.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1161\/jaha.125.041834","type":"journal-article","created":{"date-parts":[[2025,9,19]],"date-time":"2025-09-19T11:17:11Z","timestamp":1758280631000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":27,"title":["Population\u2010Based Study on the Coexistence of Metabolic Dysfunction\u2010Associated Steatotic Liver Disease and Chronic Kidney Disease"],"prefix":"10.1161","volume":"14","author":[{"given":"Rachel Sze Jen","family":"Goh","sequence":"first","affiliation":[{"name":"National University Singapore","place":["Singapore, Singapore"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jaycie","family":"Koh","sequence":"additional","affiliation":[{"name":"Nanyang Technological University","place":["Singapore, Singapore"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0003-4230-6518","authenticated-orcid":false,"given":"Made Ayu","family":"Utami Intaran","sequence":"additional","affiliation":[{"name":"National University Health System","place":["Singapore, Singapore"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8417-5996","authenticated-orcid":false,"given":"Yiphan","family":"Chin","sequence":"additional","affiliation":[{"name":"National University Hospital","place":["Singapore, Singapore"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3385-5078","authenticated-orcid":false,"given":"Gwyneth","family":"Kong","sequence":"additional","affiliation":[{"name":"National University Hospital","place":["Singapore, Singapore"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3565-7657","authenticated-orcid":false,"given":"Bryan","family":"Chong","sequence":"additional","affiliation":[{"name":"National University Hospital","place":["Singapore, Singapore"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0004-8977-4295","authenticated-orcid":false,"given":"Jobelle","family":"Chia","sequence":"additional","affiliation":[{"name":"National University Health System","place":["Singapore, Singapore"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0389-7450","authenticated-orcid":false,"given":"Mark Y","family":"Chan","sequence":"additional","affiliation":[{"name":"National University Singapore","place":["Singapore, Singapore"]},{"name":"National University Health System","place":["Singapore, Singapore"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6910-5551","authenticated-orcid":false,"given":"Anurag","family":"Mehta","sequence":"additional","affiliation":[{"name":"Virginia Commonwealth University School of Medicine","place":["Richmond, USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9724-4743","authenticated-orcid":false,"given":"Mark","family":"Muthiah","sequence":"additional","affiliation":[{"name":"National University Hospital","place":["Singapore, Singapore"]},{"name":"National University Health System","place":["Singapore, Singapore"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1250-6351","authenticated-orcid":false,"given":"Muhammad Shahzeb","family":"Khan","sequence":"additional","affiliation":[{"name":"Baylor Scott and White Research Institute","place":["Dallas, USA"]},{"name":"The Heart Hospital Plano","place":["Plano, USA"]},{"name":"Baylor College of Medicine","place":["Temple, USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0640-0430","authenticated-orcid":false,"given":"Nicholas WS","family":"Chew","sequence":"additional","affiliation":[{"name":"National University Singapore","place":["Singapore, Singapore"]},{"name":"National University Health System","place":["Singapore, Singapore"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"e_1_3_2_2_2","unstructured":"Organization WH . 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