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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