Whilst carriage of the PNPAL3‐I148M variant was not associated with an increased risk of prevalent CKD, in the fully adjusted analysis, participants with both MetS and significant liver fibrosis (FIB‐4 > 2.67) had the highest risk of prevalent CKD compared to those without any of the explored risk factors (SLD, MetS, risk of liver fibrosis or PNPLA3‐I148M) (OR 4.29, 95% CI 3.36–5.47, p < 0.0001) regression analyses (Table 5). This evidence concerns the gene PNPLA3 and metabolic syndrome.