# MAFLD in Egyptian non-dialysis CKD Patients: Frequency, fibrosis severity, and risk factors

## TL;DR

This study finds that over half of Egyptian non-dialysis CKD patients have MAFLD, with higher rates linked to age, obesity, diabetes, and kidney disease severity.

## Contribution

The study reports the first detailed assessment of MAFLD prevalence and risk factors in Egyptian non-dialysis CKD patients.

## Key findings

- MAFLD prevalence was 59.25% in non-dialysis CKD patients.
- MAFLD was strongly associated with diabetes, hypertension, and lower eGFR.
- Liver stiffness and advanced fibrosis were more common in MAFLD patients.

## Abstract

The prevalence of Metabolic Dysfunction-Associated Fatty Liver Disease (MAFLD) in non-dialysis chronic kidney disease (CKD) patients remains underexplored, particularly in high-risk populations such as Egyptians with high rates of metabolic disorders.

This study aimed to determine the frequency of MAFLD in Egyptian non-dialysis CKD patients, assess liver fibrosis severity, and identify associated metabolic risk factors.

A cross-sectional study of 108 CKD patients was conducted, with participants stratified into MAFLD (n = 64) and non-MAFLD (n = 44) groups. Diagnostic criteria for MAFLD included hepatic steatosis (ultrasonography) and metabolic risk factors. Non-invasive fibrosis scores (NAFLD score, FIB-4 index, APRI score) and shear wave elastography were used to evaluate liver fibrosis.

MAFLD prevalence was 59.25%. MAFLD patients exhibited significant associations with older age (56 ± 17.1 vs. 43 ± 17.1 years, p < 0.001), higher BMI (34.5 ± 6.2 vs. 27.2 ± 5.7 kg/m2, p < 0.001), diabetes (48.4% vs. 4.5%, p < 0.001), hypertension (68.7% vs. 22.7%, p < 0.001), and insulin resistance (HOMA-IR: 3.5 ± 3.6 vs. 1.45 ± 1.03, p < 0.001). MAFLD patients also had lower eGFR (40.5 ± 28.0 vs. 58.9 ± 39.9 mL/min/1.73 m2, p = 0.017) and higher liver stiffness (7.6 ± 1.8 vs. 6.9 ± 1.7 kPa, p = 0.047), with advanced fibrosis more prevalent in later CKD stages..

MAFLD is highly prevalent among non-dialysis CKD patients, driven by shared metabolic abnormalities and CKD severity. These findings highlight the bidirectional relationship between MAFLD and CKD, emphasizing the need for integrated screening and management strategies to mitigate progression risks in this population.