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Subject Area

Pathology

Article Type

Original Study

Abstract

Objective To explore the association between the presence of nonalcoholic fatty liver disease (NAFLD) and chronic kidney disease in type 2 diabetic patients. Background NAFLD is the most common cause of chronic liver disease worldwide. The histologic spectrum of NAFLD ranges from simple steatosis to nonalcoholic steatohepatitis, liver fibrosis, and cirrhosis. Patients and methods A prospective randomized comparative study was conducted during March 2018 to February 2019 on 40 type 2 diabetic patients, who were classified into two groups: group I included 20 patients with type 2 diabetes with fatty liver, and they were classified by ultrasound into patients with mild, moderate, and severe fatty liver, and group II consisted of 20 patients with type 2 diabetes without fatty liver. Full history was taken, and routine examination, physical examination, and special investigations were done. Results The mean albumin/creatinine ratio in group I was higher than in group II (77.24 ± 89.98 and 10.94 ± 2.76, respectively), and the difference was statistically significant (t = 3.294, P = 0.004). Estimated glomerular filtration rate was lower in group I than in group II, and the difference was statistically insignificant. Estimated glomerular filtration rate mean value was higher in patients with mild degree of fatty liver, and the differences were statistically insignificant. Albumin/creatinine ratio, serum creatinine, and serum uric acid were higher in patients with severe fatty liver, and the differences were statistically significant (t = 3.542, P = 0.024; t = 3.132, P = 0.037; and t = 7.647, P = 0.000, respectively). Conclusion Kidney injury in diabetic patients with NAFLD was higher than in diabetic patients without fatty liver and was obvious in those with severe degree of fatty liver. NAFLD is associated with an increased frequency of chronic kidney disease in type 2 diabetic patients.

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