Acute kidney and liver injury in chronic alcohol intoxication

Murkamilov I.T., Aitbaev K.A., Fomin V.V., Murkamilova Zh.A., Raimzhanov Z.R., Solizhonov Zh.I., Yusupov A.F., Yusupov F.A., Yusupova T.F., Khabibullaev K.K.

1) Kyrgyz State Medical Academy named after I.K. Akhunbaev, Bishkek, Kyrgyzstan; 2) Salymbekov University, Bishkek, Kyrgyzstan; 3) Russian Medical Academy of Continuous Professional Education, Moscow, Russia; 4) Family Medicine Center №7, Bishkek, Kyrgyzstan; 5) N.N. Burdenko Main Military Clinical Hospital, Moscow, Russia; 6) Republican Specialized Scientific and Practical Medical Center for Nephrology and Kidney Transplantation, Tashkent, Uzbekistan; 7) Osh State University, Osh, Kyrgyzstan

Background. Alcoholism is a serious medical, social and economic problem of the 21st century. Regular alcohol consumption in a dose of 60-80 g/day or at least three times a week or a single consumption of ≥300 ml of vodka increases the risk of developing structural and functional changes in the kidneys, liver, pancreas, central nervous system and heart. Acute kidney injury (AKI) is a widespread polyetiological syndrome characterized by a sharp decrease in renal filtration (hypercreatininemia, decreased glomerular filtration rate, decreased diuresis). In alcohol intoxication, liver damage
of varying severity is often detected, and the presence of AKI worsens the prognosis of the disease. However, with timely diagnosis and adequate therapy, AKI is reversible in most cases.
Description of the clinical case. The article considers a case of liver damage complicated by AKI in an elderly patient with obesity who had been abusing alcohol for a long time. According to the clinical and laboratory examination conducted at the time of hospitalization and during treatment, the following changes in peripheral blood parameters were noted: leukocytes (24,6×10⁹/l → 7,5×10⁹/l), platelets (603×10⁹/l → 446×10⁹/l), C-reactive protein (240,7 mg/l → 95,7 mg/l), γ-glutamyl transpeptidase (372 U/L → 175 U/L), alanine aminotransferase (49,1 U/l → 27,3 U/l), D-dimer (2,54 → 3,21), creatinine (146 μmol/l → 90 μmol/l), glomerular filtration rate (43 ml/min → 80 ml/min). In addition, the patient had elevated fibrinogen, ferritin, thyroid-stimulating hormone, cystatin C, and rheumatoid factor levels. According to FibroScan, grade F2 liver fibrosis was diagnosed. Instrumental examination revealed atherosclerotic lesions of the carotid and femoral arteries, left ventricle diastolic dysfunction, left atrium dilation, as well as non-erosive gastroesophageal reflux disease and erosive lesions of the gastric mucosa. The article also discusses the mechanisms of kidney and liver damage in chronic alcohol intoxication.

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About the Authors

Ilkhom T. Murkamilov – Dr.Sci. (Med.), Corresponding Member of the Russian Academy of Natural Sciences, Associate Professor at the Department of Faculty Therapy, I.K. Akhunbaev KSMA, Director of the Multidisciplinary Medical Center "Doc University Clinic", Salymbekov University. Address: 92 Akhunbaev str., Bishkek, 720020;
tel.: (+996) 557-221-983; e-mail: murkamilov.i@mail.ru. ORCID: https://orcid.org/0000-0001-8513-9279.
Kubanych A. Aitbaev – Dr.Sci. (Med.), Professor, Department of Intensive Care Medicine, Therapy and Diagnostics, Salymbekov University. Address: 144 Bokonbaev str.,
Bishkek, 720040; tel.: (+996) 555-758-476; e-mail:aitbaev.kuban1940@gmail.com. ORCID: https://orcid.org/0000-0003-4973-039X.
Viktor V. Fomin – Dr.Sci. (Med.), Professor, Academician of the Russian Academy of Sciences, Rector of the Russian Medical Academy of Continuing Professional Education. Address: 125993, Moscow, Barrikadnaya str., 2/1, p. 1., e-mail: fomin_vic@mail.ru. ORCID ID:0000-0002-2682-4417.
Zhamila A. Murkamilova – is a therapist at Family Medicine Center №7. Address: 720040 Bishkek, T. Moldo Street 3; phone: +999091185. e-mail: murkamilovazh.t@mail.ru. ORCID: https://orcid.org/0000-0002-7653-0433.
Zafarbek R. Rayimzhanov – is a neurologist at the 29th Neurological Department of the N.N. Burdenko Main Military Clinical Hospital, Address: 3 Hospital square, Moscow, 105094; Тел: 8-499-263-55-55; rzrmam@mail.ru ORCID: 0000-0001-5746-6731
Zhaloliddin I. Solizhonov – is a clinical resident at the Republican Specialized Scientific and Practical Medical Center for Nephrology and Kidney Transplantation.
Address: 9 Yangi Shahar Street, Tashkent 100194; phone: (+495) 967-4690-0438;e-mail:jaloliddinsolijonov44@gmail.com. ORCID:https://orcid.org/0009-0003-0078-0609.
Abdulhokim F. Yusupov – research physician, Department of Neurology, Neurosurgery and Psychiatry, Medical Faculty, Osh State University. Address: 331 Lenin St., Osh, 723500; tel.: (+996) 707-130-938; e-mail: zulkhumor.yusupova.f_05@mail.ru. ORCID: https://orcid.org/0000-0002-6449-8229
Furkat A. Yusupov – Dr. Sci. (Med.), Professor, Head of the Department of Neurology, Neurosurgery and Psychiatry, Medical Faculty, Osh State University.
Address: 331 Lenin str., Osh, 723500; Tel.: (+996) 990-999-291; E-mail: furcat_y@mail.ru. ORCID: https://orcid.org/0000-0003-0632-6653.
Tursunoy F. Yusupova – Clinical Resident of the Department of Neurology, Neurosurgery and Psychiatry, Medical Faculty, Osh State University. Address: 331 Lenin str., Osh, 723500; tel.: (+996) 707-130-938; e-mail: yusupova_tursunoy_f@mail.ru. ORCID: https://orcid.org/0000-0002-8502-2203.
Komil K. Khabibullaev – 6th-year student of the Faculty of Medicine, I.K. Akhunbaev KSMA. Address: 92 Akhunbaev str., Bishkek, 720020; Tel.: (+996) 706-474-201,
e-mail: khabibullaevkomil2001@gmail.com. ORCID: https://orcid.org/0009-0004-5508-8019.

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