The Entanglement between Metabolic Associated Non- Alcoholic Fatty liver Disease and Chronic Kidney Disease Progression is more than just a Strong Correlation. A Narrative Review

The aim of this narrative review is to shed light on the correlation between metabolic-associated fatty liver disease (MAFLD) and chronic kidney disease progression (CKD). There is robust evidence from the current and recent literature that MAFLD is strongly associated with CKD incidence and progression regardless of other confounding factors such as DM, hypertension, dyslipidemia, age, and gender. we believe that MAFLD and CKD are two important health issues, both have a global and economic burden that will continue to rise over the coming years. Primary and secondary care physicians, particularly nephrologists should be fully aware of the impact of MAFLD on CKD patients so they can participate actively in the management plan of these patients to reduce the comorbidities and economic costs associated with it. Methodology: The review identified and included the most recent few studies that described the problem of interest. Recommendations are given based on our perception, interpretation, and synthesis of data from the reviewed literature. Results: The existence of a strong correlation between MAFLD and CKD was persistent across all the reviewed studies and articles. This correlation was independent of other traditional risk factors such as hypertension, diabetes mellitus, hyperlipidemia, gender, and age. Conclusion: The global prevalence of MAFLD among the general population is high reaching 30% and almost 50% of CKD patients have MAFLD. There is a strong and independent association between MAFLD and CKD incidence and progression, thus patients diagnosed with CKD should be screened for MAFLD and managed accordingly to prevent and delay CKD progression.