ISSN 2415-3060 (print), ISSN 2522-4972 (online)
  • 36 of 61
УЖМБС 2019, 4(5): 238–243
Clinical Medicine

The Features of the Nonalcoholic Steatosis and Steatohepatitis depending on the Presence of Comorbid Chronic Kidney Disease

Khukhlina O. S., Antoniv A. A., Mandryk O. Ie., Lyakhovich O. D., Kosar L. Yu.

The purpose of the study was to find out the likely changes in the liver of patients with non-alcoholic liver steatosis and steatohepatitis depending on the presence of comorbid chronic kidney disease and obesity. Material and methods. 384 patients with non-alcoholic fatty liver disease were examined: 84 of them with non-alcoholic fatty liver disease with obesity of the I degree (1 group). This group contained 2 subgroups: 32 patients with non-alcoholic steatosis and 52 patients with non-alcoholic steatohepatitis. Group 2 included 270 patients with non-alcoholic fatty liver disease with comorbid obesity of the I degree and chronic kidney disease І-ІІІ stage, 110 of them were with non-alcoholic steatosis and 160 patients with non-alcoholic steatohepatitis. The control group consisted of 90 patients with chronic kidney disease of the І-ІІІ stage with normal body weight (group 3). The average age of patients was (45.8 ± 3.81) years. Results and discussion. The study showed that in the case of patients with chronic kidney disease, the index of steatosis in the liver was 3.5 times higher than in the practically healthy persons (p <0.05), whereas in patients with NASH it was 4.6 fold higher (p <0,05) with the presence of a probable difference between the groups (p <0,05). The analysis of the NASH-test indicates that metabolic syndrome with the development of probable (possible) non-alcoholic steatohepatitis (increase in the rate of 2.6 times, p <0.05) in patients with non-alcoholic steatosis with chronic kidney disease. Conclusions. The comorbidity of non-alcoholic steatohepatitis with chronic kidney disease was characterized by a higher degree of liver steatosis (hepatorenal index 1.3 times higher than the group of patients with NASH, p <0.05), and the higher diagnostic threshold of values of the hepatotoxic index, which in strong interdependence correlates with the degree of steatosis of the liver, determined by Steato-test (r = 0.87; p <0.001). The prospect of further research in this direction is development of methods for prevention and correction of established changes in patients depending on the form of non-alcoholic fatty liver disease for comorbidity with chronic kidney disease.

Keywords: non-alcoholic fatty liver disease, chronic kidney disease, obesity, hepatorenal index

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  1. Babak OYa, Kolesnikova EV, Syitnik KA. Profilakticheskie meropriyatiya pri nealkogolnoy zhirovoy bolezni pecheni: suschestvuet li sposob snizit risk razvitiya zabolevaniya? [Preventive measures for non-alcoholic fatty liver disease: is there a way to reduce the risk of the disease?]. Suchasna gastroenterol. 2013; 3(71): 103-9. [Russian]
  2. Kolesnyk MO, Gholubchykov MV, Sajdakova NO, ta in. Klasyfikacija khvorob sechovoji systemy ta vedennja reghionaljnykh ta nacionaljnogho rejestriv khvorykh z khronichnoju khvoroboju nyrok: Metod rekomendaciji MOZ Ukrajiny, AMN Ukrajiny, Ukr Centr naukovoji med informaciji i patentno-licenzijnoji roboty. K; 2006. 24 s. [Ukrainian]
  3. Baltieri L, Chaim EA, Chaim FDM, Utrini MP, Gestic MA, Cazzo E. Correlation between nonalcoholic fatty liver disease features and levels of adipokines and inflammatory cytokines among morbidly obese individuals. Arq Gastroenterol. 2018; 55(3): 247-51.
  4. Bellizzi V, Cupisti A, Locatelli F, Bolasco P, Brunori G, Cancarini G, et al. “Conservative Treatment of CKD” study group of the Italian Society of Nephrology. Low-protein diets for chronic kidney disease patients: the Italian experience. BMC Nephrol. 2016; 17(1): 77.
  5. Grander C, Grabherr F, Moschen AR, Tilg H. Non-alcoholic fatty liver disease: Cause or effect of metabolic syndrome. Visc Med. 2016; 32(5): 329-34.
  6. Gray SP, Di Marco E, Okabe J, Szyndralewiez C, Heitz F, Montezano AC, et al. NADPH oxidase 1 plays a key role in diabetes mellitus-accelerated atherosclerosis. Circulation. 2013; 127 (18): 1888-902.
  7. Khukhlina OS, Antoniv AA, Dudka IV, Dudka T, Mandryk O. Peculiarities of the clinical course of non-alcoholic steatohepatitis against the background of the chronic kidney disease of the І-ІІІ stage with secondary arterial hypertension. Georgian Medical News. 2017; 9(270): 59-65.
  8. Khukhlina OS, Antoniv AA, Kanovska LV, Mandryk O, Smandych V. The effectiveness of non-alcoholic steatohepatitis correction on the background of obesity with chronic kidney disease. Georgian Medical News. 2018; 10(283): 76-80.
  9. Khukhlina OS, Antoniv AA, Kanovska LV, et al. The intensity of the antioxidant protection system and oxidative stress factors in patiencts with non-alcoholic steatohepatitis depending on the form of chronic kidney disease. Georgian Medical News. 2018; 3(276): 71-6.
  10. Noureddin M, Mato JM, Lu SC. Nonalcoholic fatty liver disease: update on pathogenesis, diagnosis, treatment and the role of S-adenosylmethionine. Exp Biol Med (Maywood). 2015; 240(6): 809-20.
  11. Zhang X, Lerman LO. The metabolic syndrome and chronic kidney disease. Transl Res. 2017 May; 183: 14-25.
  12. Zhao H, Song X, Li Z, Wang X. Risk factors associated with nonalcohol fatty liver disease and fibrosis among patients with type 2 diabetes mellitus. Medicine (Baltimore). 2018; 97(37): e12356.