THE COURSE OF CHRONIC KIDNEY DISEASE (CHRONIC PYELONEPHRITIS) IN PATIENTS WITH NON-ALCOHOLIC FATTY LIVER DISEASE AND OBESITY

  • Aliona A. Antoniv Department of Internal Medicine, Clinical Pharmacology, and Occupational Diseases, Bukovinian State Medical University, Chernivtsi, Ukraine
  • Zoriana Ya. Kotsyubiychuk Department of Internal Medicine, Clinical Pharmacology, and Occupational Diseases, Bukovinian State Medical University, Chernivtsi, Ukraine
  • Volodymyr V. Vivsyanyk Department of Internal Medicine, Clinical Pharmacology, and Occupational Diseases, Bukovinian State Medical University, Chernivtsi, Ukraine
  • Vitaliy S. Smandych Department of Internal Medicine, Clinical Pharmacology, and Occupational Diseases, Bukovinian State Medical University, Chernivtsi, Ukraine
  • Lyudmyla V. Kanyovska Department of Internal Medicine, Clinical Pharmacology, and Occupational Diseases, Bukovinian State Medical University, Chernivtsi, Ukraine
  • Olga Ye. Mandryk Department of Internal Medicine, Clinical Pharmacology, and Occupational Diseases, Bukovinian State Medical University, Chernivtsi, Ukraine
  • Oksana D. Liakhovych Department of Internal Medicine, Clinical Pharmacology, and Occupational Diseases, Bukovinian State Medical University, Chernivtsi, Ukraine
Keywords: chronic kidney disease, chronic pyelonephritis, non-alcoholic liver steatosis, non-alcoholic steatohepatitis

Abstract

The aim of the research: to investigate the features of the comorbid course of chronic kidney disease (CKD) (chronic pyelonephritis), non-alcoholic fatty liver disease and obesity, depending on the stage of CKD.

Material and methods of research. To achieve this goal, 250 patients with chronic kidney disease (CKD) (chronic bilateral pyelonephritis) stage I–III were examined, of which 160 patients had concomitant NASH and class 1 obesity (1 group) and 90 people had CKD stage I–III without NASH and obesity (group 2). Depending on the stage of CKD, patients of group 1 were divided into 3 subgroups: with CKD stage I – 63 patients, with CKD stage II – 52 patients, with CKD stage III – 45 patients. Patients of group 2 were also divided into 3 subgroups: with CKD stage I – 32 patients, with CKD stage II – 31 patients, with CKD stage III – 27 patients.

The control group included 30 apparently healthy individuals (AHIs). The average age of patients was 49.8 ± 5.8 years. The study did not include patients with CKD stage I–III with nephrotic syndrome and patients with chronic uncomplicated pyelonephritis in the phase of exacerbation.

Research results. According to the results of our study, we noted a probable effect of nonalcoholic steatosis and steatohepatitis on the functional state of the kidneys in patients with stage I–III CKD: significant changes in glomerular filtration rate, nitrogen excretory function, increased hypoalbuminemia, increased protein in the urine, erythrocytes, leukocytes, the presence of bacteria, compared with patients with CKD without comorbidity. There was a significant correlation between a decrease in glomerular filtration rate (GFR), an increase in the intensity of oxidative stress, a decrease in blood glutathione, hydrogen sulfide, hyperproduction of homocysteine, cytokeratin-18, connective tissue components (collagen, sialic acids).

Conclusion. In patients with CKD stage I–II without comorbid NASH and obesity, we found a significantly higher renal functional reserve in response to water-electrolyte stimulation, which is sufficient in both groups of patients (increase in GFR by 28–37% vs. 19–31% for comorbidity with NASH). In patients with CKD stage III with nonalcoholic steatohepatitis we found a significantly reduced functional reserve of the kidneys (increase in GFR by 8.9% vs. 17.5% in patients without NASH), and in 4.9% of patients with comorbidity ­– no functional reserve of the kidneys (p > 0.05), indicating irreversible changes in the functional state of the kidneys.

Author Biographies

Aliona A. Antoniv, Department of Internal Medicine, Clinical Pharmacology, and Occupational Diseases, Bukovinian State Medical University, Chernivtsi, Ukraine

док. мед. наук, професор кафедри внутрішньої медицини, клінічної фармакології та професійних хвороб, Буковинський державний медичний університет, Театральна пл., 2, м. Чернівці, Україна, 58002

Zoriana Ya. Kotsyubiychuk, Department of Internal Medicine, Clinical Pharmacology, and Occupational Diseases, Bukovinian State Medical University, Chernivtsi, Ukraine

асистент кафедри внутрішньої медицини, клінічної фармакології та професійних хвороб, Буковинський державний медичний університет, Театральна пл., 2, м. Чернівці, Україна, 58002

Volodymyr V. Vivsyanyk, Department of Internal Medicine, Clinical Pharmacology, and Occupational Diseases, Bukovinian State Medical University, Chernivtsi, Ukraine

к-т мед. наук, асистент кафедри внутрішньої медицини та інфекційних хвороб, Буковинський державний медичний університет, Театральна пл., 2, м. Чернівці, Україна, 58002

Vitaliy S. Smandych, Department of Internal Medicine, Clinical Pharmacology, and Occupational Diseases, Bukovinian State Medical University, Chernivtsi, Ukraine

к-т мед. наук, асистент кафедри внутрішньої медицини, клінічної фармакології та професійних хвороб, Буковинський державний медичний університет, Театральна пл., 2, м. Чернівці, Україна, 58002

Lyudmyla V. Kanyovska, Department of Internal Medicine, Clinical Pharmacology, and Occupational Diseases, Bukovinian State Medical University, Chernivtsi, Ukraine

к-т мед. наук, доцент кафедри внутрішньої медицини, клінічної фармакології та професійних хвороб, Буковинський державний медичний університет, Театральна пл., 2, м. Чернівці, Україна, 58002

Olga Ye. Mandryk, Department of Internal Medicine, Clinical Pharmacology, and Occupational Diseases, Bukovinian State Medical University, Chernivtsi, Ukraine

к-т мед. наук, асистент кафедри внутрішньої медицини, клінічної фармакології та професійних хвороб, Буковинський державний медичний університет, Театральна пл., 2, м. Чернівці, Україна, 58002

Oksana D. Liakhovych, Department of Internal Medicine, Clinical Pharmacology, and Occupational Diseases, Bukovinian State Medical University, Chernivtsi, Ukraine

к-т мед. наук, асистент кафедри внутрішньої медицини, клінічної фармакології та професійних хвороб, Буковинський державний медичний університет, Театральна пл., 2, м. Чернівці, Україна, 58002

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Published
2021-09-29
How to Cite
Aliona A. Antoniv, Zoriana Ya. Kotsyubiychuk, Volodymyr V. Vivsyanyk, Vitaliy S. Smandych, Lyudmyla V. Kanyovska, Olga Ye. Mandryk, & Oksana D. Liakhovych. (2021). THE COURSE OF CHRONIC KIDNEY DISEASE (CHRONIC PYELONEPHRITIS) IN PATIENTS WITH NON-ALCOHOLIC FATTY LIVER DISEASE AND OBESITY. Eastern Ukrainian Medical Journal, 9(3), 228-237. https://doi.org/10.21272/eumj.2021;9(3):228-237