Background/Aims The number of patients with nonalcoholic fatty liver disease (NAFLD) and chronic kidney disease (CKD) is on the rise. Epidemiological studies have shown the role of hyperuricemia in the development of NAFLD and CKD through oxidative stress and inflammatory mediators. Therefore, this study was conducted to investigate the prevalence and risk factors of hyperuricemia in patients with CKD and NAFLD in Iran. Patients and Methods This study was conducted in 450 CKD patients. NAFLD was diagnosed by ultrasonography. According to the serum uric acid level, all CKD + NAFLD + patients were divided into non-hyperuricemia and hyperuricemia groups. The patients’ demographic and clinical data such as age, sex, abdominal obesity, metabolic syndrome, diabetes, hypertension, CRP, hepatic steatosis, blood pressure, serum uric acid (UA), lipid and creatinine were collected for analysis. Results A total of 279 cases (62%) were diagnosed with NAFLD. The prevalence rate of NFALD in CKD patients was significantly lower in normal UA level than hyperuricemia (42.7% vs 57.3%) (P=0.039). The prevalence of hyperuricemia was about 57.3% in patients with CKD and NAFLD. Accordingly, 279 CKD patients with NAFLD were enrolled and divided into hyperuricemia (n =160) and non-hyperuricemia groups (n =119). Patients with hyperuricemia showed higher creatinine and lipid levels, and a lower GFR compared to patients with normal uric acid levels (P< 0.05). However, no significant difference was observed in age, sex, abdominal obesity, metabolic syndrome, hypertension, type 2 diabetes, CRP, and steatosis between hyperuricemia and non-hyperuricemia groups (P>0.05). Three factors, including type 2 diabetes, hyperlipidemia, and a low GFR, serve as independent risk factors for hyperuricemia (P<0.05). Conclusion The results showed a high prevalence of hyperuricemia in patients with CKD and NAFLD. A more comprehensive strategic management is necessary to address the potential harmful effects of hyperuricemia on the health of CKD + NAFLD + cases.
Urinary tract infections (UTIs) are the reason for 15-70% of urinary stone disease (USD). Many diabetic patients suffer from USD resulting from bacterial infections by multi drug resistant (MDR) bacteria such as Staphylococcus aureus ATCC 43300. These bacteria can enhance struvite stones' formation in diabetic patients with UTIs. In this regard, hyperglycemia, proteinuria, and using of metformin drug may be important factors. Three parameters including glucose, metformin, and protein with their three levels of concentrations were determined by experimental design of Taguchi method to obtain optimized formation of struvite stones. Artificial urine medium was utilized for simulation of natural human urine. Scanning electron microscopy (SEM) and energy dispersive X-ray analysis (EDAX) techniques were applied for evaluation of morphology and elemental compositions of formed calcium phosphate. This study showed highest concentration of struvite stones (0.512 g/L) under interaction conditions of 3×2×2 levels respectively for glucose, metformin, and protein. Results of SEM and EDAX analyses demonstrated clumped crystallite property and flower-like nanocomposites (NCs) of struvite stones with contribution of calcium (160.8) and phosphate (131.4) elements. It may be concluded from this investigation that therapy of MDR bacteria, hyperglycemia, and proteinuria can decrease urinary stone formation in diabetic patients by having UTIs.
Usage of TauroLock as an antimicrobial drug that prevents CRB has been recommended in most studies, but the high cost of the drug prevents its widespread use in hemodialysis patients. Therefore, in this study the effect of TauroLock as a half dose for its economic advantages was investigated.
Non-alcoholic fatty liver disease and associated risk factors among hemodialysis patients. AbstractBackground: Non-alcoholic fatty liver disease (NAFLD), chronic kidney disease (CKD) have common pathogenic mechanisms and many important cardio-metabolic risk factors, thus diagnosis and treatment of NAFLD and related factors among CKD patients can potentially prevent CVD-related mortality, which is considered as the most common cause of death in CKD patients.Objective: To determine the prevalence of NAFLD and related risk factors amongst hemodialysis patients.Methods: 150 ESRD patients were included in this cross-sectional study in a 1-year period. Abdominal ultrasound was done to determine the presence of NAFLD. Risk factors and related variables including hypertension, abdominal obesity, dyslipidemia, anemia, diabetes mellitus, and qualitative C-reactive protein (CRP) were gathered.Results: The prevalence of NAFLD was 20% (30 patients). The frequency of abdominal obesity was significantly higher in the NAFLD group (73.33%) compared to ESRD patients who did not have NAFLD (23.33%); P< 0.0001. Also, hypertension was more common in the NAFLD group (90%) than in the other group (69.16%); P= 0.021. Likewise, anemia, DM, abnormally high ALT (i.e., > 20 IU/L), dyslipidemia, and positive CRP test results all were significantly higher in the NAFLD group in comparison to the other group.Conclusion: ESRD patients should be investigated for the presence of NAFLD, as it was present in about one-fifth of the studied sample. Established risk factors for CVD were significantly more common in ESRD + NAFLD patients compared to ESRD cases without NAFLD. This emphasizes more aggressive treatment of the risk factors in NAFLD patients.
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