Chinese Hepatolgy ›› 2023, Vol. 28 ›› Issue (5): 518-522.

• Chronic Liver Disease • Previous Articles     Next Articles

Clinical characteristics of nephropathy in patients with chronic liver disease combined with chronic kidney disease

KANG Wei-wei1, LIU Li-wei1, ZHANG Yuan2, ZHONG Rui1, FENG Li-li1, CHEN Yu1   

  1. 1. The Fourth Department of Liver Disease Center of Beijing You’an Hospital, Capital Medical University, Beijing Key Laboratory of Liver Failure and Artificial Liver Therapy, Beijing 100069, China;
    2. Ultrasound and Functional Diagnosis Center of Beijing You'an Hospital, Capital Medical University, Beijing 100069, China
  • Received:2022-10-25 Online:2023-05-31 Published:2023-08-29
  • Contact: CHEN Yu, Email: chybeyond1071@ccmu.edu.cn

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Abstract: Objective To investigate the clinical characteristics of chronic kidney disease (CKD) progression in patients with chronic liver disease combined with CKD.Methods Patients with chronic liver disease complicated with CKD admitted to our hospital from June 2020 to December 2021 were enrolled, they were divided into stage 1-2 group, stage 3 group and stage 4-5 group according to CKD staging. The clinical characteristics of patients in each group were compared. Logistic regression was used to analyze the risk factors for the progression of CKD to stage 4-5 in patients with chronic liver disease.Results A total of 65 patients with chronic liver disease complicated with CKD were included. With the progression of CKD staging, the levels of serum β2 microglobulin (CKD1-2 2.6 mg/L,CKD3 6.9 mg/L,CKD4-5 12.8 mg/L, P<0.001), urinary α1 microglobulin (CKD1-2 23.3 mg/L, CKD3 30.1 mg/L, CKD4-5 72.6 mg/L, P=0.001), urinary β2 microglobulin (CKD1-2 0.4 mg/L, CKD3 0.5 mg/L, CKD4-5 8.3 mg/L, P=0.005) increased significantly, while urinary creatinine (CKD1-2 8881 μmol/L, CKD3 5512 μmol/L, CKD4-5 4388 μmol/L, P<0.001) and urinary sodium (CKD1-2 111.4 mmol/L, CKD3 75.8 mmol/L, CKD4-5 73.2 mmol/L, P<0.001) decreased significantly. The resistance index of bilateral renal hilar artery (right CKD1-2 0.69,CKD3 0.77,CKD4-5 0.74, P=0.010, left CKD1-2 0.69, CKD3 0.76, CKD4-5 0.78, P=0.009) and segmental artery resistance index (right CKD1-2 0.66,CKD3 0.71,CKD4-5 0.72, P=0.034, left CKD1-2 0.66, CKD3 0.69, CKD4-5 0.73, P=0.027) also increased with the progression of CKD stage. Multivariate logistic regression analysis showed that higher blood retinol binding protein (OR 1.073, 95% CI 1.006-1.145; P=0.032) and serum β 2-microglobulin (OR 1.932, 95% CI 1.233-3.027; P=0.004) were independent risk factors for the progression of CKD4-5 in patients with chronic liver disease complicated with CKD.Conclusion Active monitoring of blood and urine biomarkers in patients with CKD in combination with chronic liver disease can help detect the progression of CKD in patients with chronic liver disease at an early stage and facilitate early intervention and prognosis improvement.

Key words: Chronic liver disease, Chronic kidney disease, Clinical features, Risk factors