TO STUDY THE CLINICAL, BIOCHEMICAL, SEROLOGICAL AND RADIOLOGICAL HEPATIC PROFILE IN PATIENTS OF CHRONIC KIDNEY DISEASE ON MAINTENANCE HEMODIALYSIS
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Abstract
Background: Chronic kidney disease (CKD) is a silent epidemic of the 21st century. Although the connection between the kidney and liver is well recognized and intricate, it is still not entirely understood. Hepatic disorders in CKD may range from mild form of transaminitis to life threatening decompensated chronic liver disease. Many of these manifestations may have correctable underlying etiologies.
Aim & Objective: To study the spectrum of clinical, hepatic biochemical, serological and radiological profile in patients of CKD on maintenance hemodialysis (HD).
Methodology: The present study was a prospective observational study which was conducted in the Department of Gastroenterology, MMIMSR, Mullana from January 2023 to January 2024 with a sample size of 100 patients. All indoor and outdoor cases of CKD were enrolled for the study and screened for various hepatic complaints. Written informed consent and institutional ethical clearance was obtained in all the cases. Complete anonymity of the patient was maintained in all the cases. All the selected patients were subjected to various biochemical, serological, and radiological investigations.
Results: The mean age of subjects was 55.5 years. 71% were male and 29% were female. The most common etiology of CKD was systemic arterial hypertension (39%). During serological examination, 16% were positive for Anti HCV Ab while 11% were positive for HBsAg and only 2% were positive for HIV. It was observed that AST (SGOT), ALT (SGPT), GGT and Serum albumin mean values were on lower side in patients of CKD on maintenance HD. On Ultrasonography, 40% subjects had normal liver while 29% had Grade 1 fatty liver, 15% had Grade 2 fatty liver, 2% had Grade 3 fatty liver and 14% had chronic liver disease.
Conclusion: In summary, our study reinforces that hepatic disease is common and manifests in multiple ways in CKD subjects, likely due to the intricate interplay between liver and kidney functions. CKD potentially initiates and exacerbates early stages of hepatic disease, progressing to more severe states. A comprehensive, interdisciplinary approach is essential, necessitating collaboration between hepatologists and nephrologists for timely and effective management of these patients.
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Dr Karwa Mohit Brijmohan
Dr Karwa Mohit Brijmohan, Senior Resident, Department of Gastroenterology, MMIMSR, Mullana.
Dr Vivek Ahuja
Dr Vivek Ahuja, Associate Professor, Department of Gastroenterology, MMIMSR, Mullana.
Dr Sudhir Mehta
Dr Sudhir Mehta, Associate Professor, Department of Nephrology, MMIMSR, Mullana
Dr Aakash Aggarwal
Assistant Professor, Department of Gastroenterology, MMIMSR, Mullana.