KP activation triggering elevated expression of KP metabolic enzymes is well documented in a range of renal (e.g., acute kidney injury (AKI), chronic kidney disease (CKD), polycystic kidney disease (PKD)) [1,6,7] and hepatic (e.g., acute-on-chronic liver failure (ACLF) in cirrhosis, hepatic encephalopathy, and non-alcoholic fatty liver disease (NAFLD)) [8–11] disorders. The gene discussed is NPPA; the disease is metabolic dysfunction-associated steatotic liver disease.