Training the next generation of hepatologists for the cardiovascular–kidney–metabolic era

As metabolic dysfunction-associated steatotic liver disease changes the clinical profile and care needs of patients with liver disease, hepatology training must extend beyond traditional organ-based boundaries. Hepatologists will increasingly need skills in cardiovascular, kidney and metabolic risk assessment, treatment co-management and referral, alongside their core expertise in liver disease.

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All authors reviewed and revised the resulting text and take full responsibility for the accuracy, integrity and content of the manuscript. Author information Authors and Affiliations MAFLD Research Center, Department of Hepatology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China Xiao-Dong Zhou ( 周晓东 ) & Ming-Hua Zheng ( 郑明华 ) Key Laboratory of Diagnosis and Treatment for the Development of Chronic Liver Disease in Zhejiang Province, Wenzhou, China Xiao-Dong Zhou ( 周晓东 ) & Ming-Hua Zheng ( 郑明华 ) Department of Hepatology and Gastroenterology, Campus Virchow-Klinikum (CVK) and Campus Charité Mitte (CCM), Charité — Universitätsmedizin Berlin, Berlin, Germany Frank Tacke Metabolic Dysfunction-Associated Steatotic Liver Disease Research Center, Division of Gastroenterology and Hepatology, Department of Medicine, University of California, San Diego, La Jolla, CA, USA Rohit Loomba CUNY Graduate School of Public Health and Health Policy (CUNY SPH), New York, NY, USA Jeffrey V.

Lazarus Barcelona Institute for Global Health (ISGlobal), Barcelona, Spain Jeffrey V. Lazarus Division of Gastroenterology and Hepatology, Department of Medicine, New York-Presbyterian Hospital/Weill Cornell Medical Center, New York, NY, USA Jeffrey V. Lazarus Department of Pathophysiology and Transplantation, Università degli Studi di Milano, Milan, Italy Luca Valenti Precision Medicine Lab, Biological Resource Center Unit, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico di Milano, Milan, Italy Luca Valenti Division of Cardiology, Department of Medicine, Emory Clinical Cardiovascular Research Institute; and Emory University School of Medicine, Atlanta, GA, USA Laurence S.

Sperling Beatty Liver and Obesity Research Program, Inova Health System, Falls Church, VA, USA Zobair M. Younossi The Global NASH/MASH Council, Center for Outcomes Research in Liver Diseases, Washington, DC, USA Zobair M. Younossi Storr Liver Centre, Westmead Institute for Medical Research, Westmead Hospital and University of Sydney, Sydney, New South Wales, Australia Jacob George Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore Mark Muthiah Division of Gastroenterology and Hepatology, Department of Medicine, National University Health System, Singapore, Singapore Mark Muthiah Division of Gastroenterology, Hepatology and Nutrition, Department of Internal Medicine, Virginia Commonwealth University School of Medicine, Richmond, VA, USA Arun Sanyal Authors Xiao-Dong Zhou ( 周晓东 ) Frank Tacke Rohit Loomba Jeffrey V.

Lazarus Luca Valenti Laurence S. Sperling Zobair M. Younossi Jacob George Mark Muthiah Arun Sanyal Ming-Hua Zheng ( 郑明华 ) Corresponding author Correspondence to Ming-Hua Zheng ( 郑明华 ) .

Ethics declarations Competing interests F.T.’s lab has received research grants (funding to the institution) from MSD and Agomab. F.T. has received honoraria for consulting or lectures from Gilead, AbbVie, Falk, AstraZeneca, Boehringer, Madrigal, MSD, GSK, Ipsen, Pfizer, Novartis, Novo Nordisk and Sanofi.

R.L. serves as a consultant to Aardvark Therapeutics, Altimmune, Arrowhead Pharmaceuticals, AstraZeneca, Cascade Pharmaceuticals, Eli Lilly, Gilead, Glympse Bio, Inipharmа, Intercept, Inventiva, Ionis, Janssen, Lipidio, Madrigal, Neurobo, Novo Nordisk, Merck, Pfizer, Sagimet, 89bio, Takeda, Terns Pharmaceuticals and Viking Therapeutics.

R.L. has stock options in Sagimet Biosciences. In addition, his institution has received research grants from Arrowhead Pharmaceuticals, AstraZeneca, Boehringer Ingelheim, Bristol-Myers Squibb, Eli Lilly, Galectin Therapeutics, Gilead, Intercept, Hanmi, Inventiva, Ionis, Janssen, Madrigal, Merck, Novo Nordisk, Pfizer, Sonic Incytes and Terns Pharmaceuticals.

J.V.L. reports speaker fees from Echosens, Gilead, Novo Nordisk and Pfizer; consulting fees from GSK, Madrigal Pharmaceuticals, Novo Nordisk, Sonic Incytes and Takeda; and grants from Echosens, Boehringer Ingelheim, Gilead, Madrigal, Novo Nordisk, Pfizer and Roche Diagnostics; outside the submitted work.

L.V. reports speaking fees from Viatris, Novo Nordisk and GSK; and consulting fees from Novo Nordisk, Pfizer, Boehringer Ingelheim, Resalis, Almac and AIRNA. Z.M.Y. has received research funding from, and/or served as a consultant or advisor to, Intercept, Cymabay, Boehringer Ingelheim, Ipsen, BMS, GSK, Novo Nordisk, Siemens, Madrigal, Merck, Aligos, Akero, Sanofi and Abbott.

J.G. has served on advisory boards and received honoraria for talks from Novo Nordisk, AstraZeneca, Roche, BMS, Pfizer, Cincera, Pharmaxis, Boehringer Mannheim, CSL, Norgine, Gilead and Eisai. M.M. serves as a consultant for Roche, Astellas and Gilead; as an advisory board member for LernaBio; and has received honoraria for paid speaking engagements from Boston Scientific, Olympus Medical, Roche, Astellas and Perspectum.

He is supported by the Singapore Ministry of Health through the National Medical Research Council (NMRC) Office and MOH Holdings under the NMRC Clinician Scientist-Individual Research Grant (MOH-001228) and Clinician Scientist Award (MOH-001631), as well as the National Research Foundation, Singapore (NRF) under the NMRC Open Fund – Large Collaborative Grant (MOH-001325), administered by the NMRC Office, MOH Holdings.

A.S. reported receiving grants from Intercept; personal consulting fees from Gilead; grants from Merck; personal consulting fees from Pfizer; grants and personal consulting fees from Eli Lilly, Novo Nordisk, Boehringer Ingelheim, Novartis and HistoIndex; stock options from Genfit, Tiziana, Durect and Inversago; personal consulting fees from Genentech, ALnylam, Regeneron, Zydus, LG Chem, Hanmi, Madrigal, PathAI and 89bio; and stock options from Galmed; outside the submitted work.

M.-H.Z. serves as a speaker for AstraZeneca, Hisky Medical Technologies and Novo Nordisk; as a consultant for Boehringer Ingelheim and Eieling Technology; and has received consulting fees from Boehringer Ingelheim. X.-D.Z. and L.S.S. declare no competing interests. About this article Cite this article Zhou, XD., Tacke, F., Loomba, R. et al.

Training the next generation of hepatologists for the cardiovascular–kidney–metabolic era. Nat Rev Gastroenterol Hepatol (2026). https://doi.org/10.1038/s41575-026-01270-0 Download citation Published : 16 October 2026 Version of record : 16 October 2026 DOI : https://doi.org/10.1038/s41575-026-01270-0