Nonalcoholic fatty liver disease or metabolic-associated fatty liver disease (MAFLD) is a common
condicion with increasing prevalence and incidence, specially in patients with type 2
diabetes mellitus (T2DM). Both cardiovascular and renal disease are clearly increased in
these patients, particularly in those with diabetic nephropathy. In the liver-heart-kidneymetabolic
axis, the common pathophysiological basis of MAFLD, cardiovascular disease
(CVD), chronic kidney disease (CKD), and T2DM is the same. The clinical relationship
between all of them is clear and is multidirectional: MAFLD may precede the development
of cardiovascular and renal disease, and may also worsen the prognosis of these complications
once developed. In this review we emphasize the importance of targeting MAFLD in
Diabetic kidney disease, with the goal of detecting high-risk patients in order to improve
their prognosis.
