Ita Jelić

Chronic Kidney Disease and Nonalcoholic Fatty Liver Disease Proven by Transient Elastography

Background/Aim: Preliminary data suggest an association between chronic kidney disease (CKD) and non-alcoholic fatty liver disease (NAFLD). The aim of this study was to further investigate the association between NAFLD and decreased kidney function. Methods: A total of 62 patients with CKD were enrolled in the study. Liver stiffness was used to detect liver fibrosis and CAP (controlled attenuation parameter) was used to detect and quantify liver steatosis (Fibroscan®). NAFLD was defined by CAP values ≥238 dB.m-1. Results: CKD stage III was present in 29 patients (46.8%) and CKD stage IV in 33 patients (53.2%). Out of 62 CKD patients 53 (85.5%) had NAFLD and of these 14/53 patients (26.4%) had also liver stiffness >7 kPa. The severity of liver steatosis was positively correlated with serum creatinine (r=0.399;p<0.01) and CRP (r=0.261; p<0.05) and negatively correlated with eGFR (r=-0.413; p<0.01) and serum iron concentration (r=-0.365; p<0.01). Conclusion: The results suggest a high prevalence of NAFLD in CKD patients. The severity of liver steatosis is negatively correlated with kidney function. The study documents the value of ultrasonographic elastography as an effective non-invasive screening method for the diagnosis of NAFLD.

Kidney Complications Due to Hematopoietic Stem Cell Transplantation-A Disorder of an Increasing Incidence?

Abstract Hematopoietic stem cell transplantation (HSCT) is becoming an increasingly popular treatment considering that it is the only curative option for many malignant and non-malignant diseases. Many patients treated in this way have been followed for two or three decades post-transplant and are presumed to be cured. But, on the other hand, a great proportion of these patients are experiencing long-term side effects after HSCT, including non-malignant organ or tissue dysfunction, changes in quality of life, infections and secondary malignancy. Renal complications caused by HSCT are high and are associated with the development of both acute and chronic kidney failure. So, considering the increasing numbers of HSCT survivors many years after the transplantation, chronic kidney disease due to HSCT is becoming a growing problem and represents a new population of patients who are presented to nephrologists. The three most common forms of chronic kidney disease related to HSCT are: chronic calcineurin nephrotoxicity, glomerular disease after HSCT and HSCT associated thrombotic microangiopathy.