Association of Kidney Stone Disease With Metabolic Dysfunction Associated Liver Disease and Metabolic Dysfunction Associated Steatohepatitis: A National Inpatient Sample Study.

Background: While many studies have identified steatotic liver disease (SLD) as a risk factor for kidney stone disease (KSD), the impact of the severity of steatosis has not been clearly elucidated in the context of other metabolic risk factors for KSD. This cross-sectional population-based study of a large inpatient database sought to investigate the association between KSD and SLD. Methods: We queried the National Inpatient Database between 2016 and 2020 to identify patients with urolithiasis as well as patients with SLD, and identify other risk factors for stone disease, such as obesity, type II diabetes, and gout using ICD10 codes. Logistic regression was computed for strength and significance of the relationship between both SLD severity levels and KSD, in univariate and multivariate regression adjusted for patient characteristics and comorbidities burden. All statistical analyses were performed using SAS Enterprise Software 9.4. Results: Odds of being a kidney stone former were significantly higher in patients with MASLD and MASH than in patients without liver injury in the general hospitalized population. Analysis performed in a cohort of hospitalizations that included BMI identifiers showed that this association of both degrees of SLD with KSD was more pronounced than that with diabetes and gout. Finally, comparing both forms of disease severity head-to-head, MASLD was found to have a stronger association with KSD than MASH. Conclusion: Patients with SLD were found to have a higher prevalence of KSD. The more pronounced association in MASLD and the lower-than-expected contribution of other conditions involving dysregulation of metabolic homeostasis such as gout or diabetes highlights the central role of SLD in KSD pathogenesis.