CLINICAL COURSE OF NON-ALCOHOLIC STEATOHEPATITIS IN COMORBIDITY WITH CHRONIC KIDNEY DISEASE OF I-III STAGES
Journal Title: Гепатологія - Year 2017, Vol 38, Issue 4
Abstract
Objective − to investigate the clinical features of NASH course and CKD of I-III stages studying the frequency and intensity of the leading clinical and biochemical syndromes of NASH. Materials and methods. We examined 105 patients with NASH: 52 patients with NASH and obesity of I degree (1 group), 53 patients with NASH, comorbid obesity of I degree and CKD of I-III stages (group 2). To determine the dependence of NASH course on CKD presence, a group of patients was randomized by age, sex, and degree of obesity. Males constituted 48 individuals, females – 57 with average age being 45.8 ± 3.81 years.Th e functional condition of the liver and kidneys was determined by the generally accepted list of enzyme activity, markers of pigment and nitrogen metabolism, lipidograms, ionograms, proteinograms, calculation of de Ritis coeffi cient, and glomerular fi ltration rate. Structural changes in the liver and kidney parenchyma were determined by ultrasonography. In order to quantify the changes in liver echogenicity we used the method of echodensitometry with calculation of the hepatorenal index. Results. Our investigation showed that the clinical course of non-alcoholic steatohepatitis in comorbidity with obesity and CKD is characterized by high frequency and intensity of clinical (asthenic-vegetative, dyspeptic, hemorrhagic, cholestatic and endocrine disorders, splenomegaly, and hepatomegaly) and biochemical (cytolytic, cholestatic, mesenchymal infl ammatory syndrome and syndrome of hepatic-cellular insuffi ciency) syndromes. Th e comorbid course of NASH with CKD is characterized by a high degree of hepatic steatosis and a higher diagnostic value threshold for hepatorenal index.
Authors and Affiliations
O Khukhlina, A Antoniv
Keywords
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