Introduction: Liver disease accounts for approximately 2 million deaths per year worldwide, 1 million due to complications of cirrhosis. About 2 billion people consume alcohol worldwide and upwards of 75 million are diagnosed with alcohol-use disorders and are at risk of alcohol-associated liver disease. Current epidemiological trends of the most common liver diseases in Asia–Pacific countries reveals that alcohol consumption, non-alcoholic fatty liver disease (NAFLD), hepatitis B virus (HBV) remains the primary cause of cirrhosis. Renal dysfunction is one of the most common complication of cirrhosis with high morbidity and mortality. The prevalence of chronic kidney disease (CKD) among patients with cirrhosis has increased due to the increased prevalence of CKD-associated comorbidities, such as diabetes [12]. Wong F et al. in 2019 observed 46.8% of chronic kidney disease (CKD) among cirrhosis patients.

Aims and Objectives: To evaluate renal function in patients of liver cirrhosis attending A.G.M.C & G.B.P.   Hospital, Agartala.

Materials and Methods: Cross Sectional hospital based study conducted in Department of  Medicine, AGMC & GBP Hospital, Agartala within a period of one and half year.  Data was analysed by SPSS software ver. 15 using appropriate statistical tests

Results: male preponderance 72 % (n=144) observed out of 200 patients of cirrhosis of liver. The mean  age of liver cirrhosis was 52.28 +/- 8.983 years. Female preponderance 70% (n=28) and 30% (n=12) males among 40 non-alcoholic liver cirrhosis patients. The commonest profile of liver cirrhosis in this current study was alcohol induced liver cirrhosis 67% (n=134) out of 200 patients.58% (n=116) were found to be diabetic and 42% (n=84) were found to be nondiabetic. 76% (n=152) was found to be only liver cirrhosis, 24% (n=48) were found to be liver cirrhosis along with chronic kidney disease. Among 24% chronic kidney disease patients, 4% (n=08) were found to be stage 3a chronic kidney disease, 2% (n=04) were found to be stage 3b chronic kidney disease, 5% (n=10) were found to be stage 4 chronic kidney disease, 13% (n=26) were found to be stage 5 chronic kidney disease. So this study revealed that end stage renal disease was most common among liver cirrhosis patients compared to other stages of chronic kidney disease. Prevalence of chronic kidney disease among non-alcoholic liver cirrhosis was more compare to alcohol related liver cirrhosis. Pearson Chi-Square test revealed strong association between non-alcoholic liver cirrhosis and chronic kidney disease with a p value of 0.003 (<0.05).Pearson Chi-Square test showed strong association with a p value of 0.039(<0.05) between diabetes and chronic kidney disease. Pearson Chi-Square test showed a strong association between serum potassium and encephalopathy with a p value of 0.003(<0.05). Pearson Chi-Square test showed a p value of 0.002(<0.05) between serum sodium and minimal encephalopathy, which showed that they have a strong association.

Conclusion: Prevalence of 24% (n=48) were found to be liver cirrhosis along with chronic kidney disease among 200 liver cirrhosis patients and 13% (n=26) were found to be stage 5 chronic kidney disease. Wong F et al study which revealed 46.8% chronic kidney disease among liver cirrhosis patients.

1.  20^th edition of Harrison’s Principles of Internal Medicine.

2. Sarin S.K , Rakhi Maiwall article. Global burden of liver disease : A true burden on health sciences and economics: World gastroenterology organisation 2018.

3.   Wong MC, Huang JL, George J, Huang J, Leung C, Eslam M, Chan HLY, Ng SC. The changing epidemiology of liver diseases in Asia-Pacific: Nat Rev Gastroenterol Hepatol. 2019 Jan;16(1):57-73.

4. WHO 2019 updates on hepatitis B .

5.  WHO 2019 updates on hepatitis C.

6. Sherlock S, Dooley J. Diseases of the Liver and Biliary System. 11^th ed. Oxford: Blackwell Publishing; 2018 edition.

7  Cholongitas E, Senzolo M, Patch D, Shaw S, O'Beirne J, Burroughs AK: Cirrhotics admitted to intensive care unit: the impact of acute renal failure on mortality. European Journal of  Gastroenterology and Hepatology ,2009;21:744-750.

8 Gines P: Pharmacological management of hepatorenal syndrome: lessons from non-responders: Journal of Hepatology, 2011;55:268-269.

9. Gluud LL, Christensen K, Christensen E, Krag A: Systematic review of randomized trials on vasoconstrictor drugs for hepatorenal syndrome: Journal of Hepatology 2010;51:576-584.

10 Piano S, Brocca A, Angeli P : Renal function in cirrhosis: A Critical Review of Liver Dis. 2018 Aug;38(3):230-241.

11 Klinicki bolnicki centar Zagreb, Medicinski fakultet Sveucilista u Zagrebu,Chronic   liver diseases in patients with chronic kidney disease : Journal of Acta Med croatica 2011;65(4):349-53.

Wong F, Reddy KR, O'Leary JG, Tandon P, Biggins SW, Garcia-Tsao G et al. Impact of Chronic Kidney Disease on Outcomes in Cirrhosis: Journal of Liver Transplantation.2019 Jun; 25(6):870-880.

12. Cullaro G, Verna EC, Lai JC. Association Between Renal Function Pattern and Mortality in Patients with Cirrhosis: Clinical Journal of Gastrohepatology, 2019 Feb 1;19(7)347 -349.

13 Theresa Bucsics, Elisabeth Krones Renal dysfunction in cirrhosis: acute kidney injury and the hepatorenal syndrome Gastroenterology Report, 2017 May; 5(2):127–137.

14. Giovanni Musso , Maurizio Cassader , Solomon Cohney , Franco De Michieli , Silvia Pinach  etal. Fatty Liver and Chronic Kidney Disease: Novel Mechanistic Insights and Therapeutic Opportunities Diabetes Care 2016 Oct; 39(10): 1830-1845.

15. McCulloughK, Sharma P, Ali T, et alMeasuring the population burden of chronic kidney disease: a systematic literature review of the estimated prevalence of impaired kidney  function: Nephrol Dial Transplant 2012;27:1812–
16. Wong F, Nadim MK, Kellum JA, etal. Working Party proposal for a revised classification   system of renal dysfunction in patients with cirrhosis: Journal of  renal physiology, 2011 May;60(5):702-9.

17. PalmerSC, Mavridis D, Navarese E, et al  Comparative efficacy and safety of blood pressure-  lowering agents in adults with diabetes and kidney disease: a network meta analysis. Lancet 2015;385:2047–2056.
18. MussoG, Gambino R, Tabibian JH, et al Association of non-alcoholic fatty liver disease with chronic kidney disease: a systematic review and meta-analysis. PLoS Med 2014;11:e1001680.
19. Stepanova M, de Avila L, Birerdinc A, et al. In female patients with non alcoholic fatty liver   disease (NAFLD) presence, of type 2 diabetes (DM) and chronic kidney disease (CKD) are  independently associated with the risk of mortality: Hepatology 2015;62(Suppl.):2205.
20. Liang Shuo Hu, Jacob George, and Jian Hua Wang Current concepts on the role of nitric oxide in portal hypertension: World J Gastroenterol,2013 Mar 21;19(11): 1707–1717.
21.  WHO report (2018) of alcohol consumption in india.
22. Massey VL, Arteel GE. Acute alcohol-induced liver injury: Journal of Physiology 2012;3:193
23. Bruha R,Dvorak K, Petrtyl J. Alcoholic liver disease: World J Hepatol 2012;4:81-90.
24. Babor TF The Classifications of Alcoholics Available from: https://www.pubs.niaaa.nih.gov/publications/ahrw20-1/06–14.pdf.
25. Skinner HA, Allen BA. Alcohol dependence syndrome Measurement and validation:Journal Abnormal Psycho 2001;91:199-209.
26. Mann RE, Smart RG, Govoni R. The epidemiology of alcoholic liver disease:Alcohol Research Health, 2003;27:209-19.

27. Arteel GE. Build a better mouse model, and the world will beat a path to your door: Journal of  Hepatology, 2013 Nov;58(5):1526–1528. 
28. Tsukamoto H, French SW, Reidelberger RD, Largman C. Cyclical pattern of blood alcohol levels during continuous intragastric ethanol infusion in rats: Alcoholism, clinical and experimental research. 1985 Jan-Feb;9(1):31–37.
29. Setshedi M, Wands JR, Monte SM. Acetaldehyde adducts in alcoholic liver disease:  Oxidative medicine and cellular longevity. 2010 May-Jun;3(3):178–185. 
30. Ji C, Chan C, Kaplowitz N. Predominant role of sterol response element binding proteins (SREBP) lipogenic pathways in hepatic steatosis in the murine intragastric ethanol feeding model: Journal of hepatology. 2006 Nov;45(5):717–724.
31. Li HH, Tyburski JB, Wang YW, et al. Modulation of fatty acid and bile acid metabolism by peroxisome proliferator-activated receptor alpha protects against alcoholic liver disease: Alcoholism, clinical and experimental research. 2014 Jun;38(6):1520–1531. 
32. Nath B, Levin I, Csak T, et al. Hepatocyte-specific hypoxia-inducible factor-1alpha is a determinant of lipid accumulation and liver injury in alcohol-induced steatosis in mice: 2011 May;53(5):1526–1537. 
33. Pritchard MT, McMullen MR, Stavitsky AB, et al. Differential contributions of C3, C5, and decay-accelerating factor to ethanol-induced fatty liver in mice: 2007 Mar;132(3):1117–1126.
34. Kaiser JP, Beier JI, Zhang J, et al. PK Cepsilon plays a causal role in acute ethanol-induced steatosis: Archives of biochemistry and biophysics. 2009 Feb;482(1-2):104–111. 
35. McKim SE, Gabele E, Isayama F, et al. Inducible nitric oxide synthase is required in alcohol-induced liver injury: studies with knockout mice: Journal of 2003 Dec;125(6):1834–1844. 
36. Petrasek J, Iracheta-Vellve A, Csak T, et al. STING-IRF3 pathway links endoplasmic reticulum stress with hepatocyte apoptosis in early alcoholic liver disease: Journal of genetics ,2013 Oct 8;110(41):16544–16549. 
37. Petrasek J, Dolganiuc A, Csak T, et al. Interferon regulatory factor 3 and type I interferons are protective in alcoholic liver injury in mice by way of crosstalk of parenchymal and myeloid cells: Journal of  2011 Feb;53(2):649–660. 
38. Markwick LJ, Riva A, Ryan JM, et al. Blockade of PD1 and TIM3 restores innate and adaptive immunity in patients with acute alcoholic hepatitis: Journal of Gastroenterology, 2015 Mar;148(3):590–602. .
39. Kakiyama G, Pandak WM, Gillevet PM, et al. Modulation of the fecal bile acid profile by gut microbiota in cirrhosis: Journal of hepatology, 2013 May;58(5):949–955. 
40. Elamin EE, Masclee AA, Dekker J, Jonkers DM. Ethanol metabolism and its effects on the intestinal epithelial barrier: Nutrition reviews,2013 Jul;71(7):483–499
41. Parlesak A, Schafer C, Schutz T, Bode JC, Bode C. Increased intestinal permeability to macromolecules and endotoxemia in patients with chronic alcohol abuse in different stages of alcohol-induced liver disease: Journal of hepatology. 2000 May;32(5):742–747.
42. Adachi Y, Moore LE, Bradford BU, Gao W, Thurman RG. Antibiotics prevent liver injury in rats following long-term exposure to ethanol: Journal of Gastroenterology,1995 Jan;108(1):218–224. 
43. Uesugi T, Froh M, Arteel GE, Bradford BU, Thurman RG. Toll-like receptor 4 is involved in the mechanism of early alcohol-induced liver injury in mice: Journal of 2001 Jul;34(1):101–108.
44. Zhong W, McClain CJ, Cave M, Kang YJ, Zhou Z. The role of zinc deficiency in alcohol-induced intestinal barrier dysfunction: American journal of physiology. Gastrointestinal and liver physiology. 2010 May;298(5):G625–633. 
45. Yin H, Hu M, Zhang R, Shen Z, Flatow L, You M. MicroRNA-217 promotes ethanol-induced fat accumulation in hepatocytes by down-regulating SIRT1: The Journal of biological chemistry,2012 Mar 23;287(13):9817–9826.
46. Tan X, Sun X, Li Q, et al. Leptin deficiency contributes to the pathogenesis of alcoholic fatty liver disease in mice. The American journal of pathology. 2012 Oct;181(4):1279–1286. 
47. Zhong W, Zhao Y, Tang Y, et al. Chronic alcohol exposure stimulates adipose tissue lipolysis in mice: role of reverse triglyceride transport in the pathogenesis of alcoholic steatosis: The American journal of pathology. 2012 Mar;180(3):998–1007. 
48. Wei X, Shi X, Zhong W, et al. Chronic alcohol exposure disturbs lipid homeostasis at the adipose tissue-liver axis in mice: Journal of Biochemistry 2013 Aug;(2):553-582.
49. Zhong W, Zhao Y, Sun X, Song Z, McClain CJ, Zhou Z. Dietary zinc deficiency exaggerates ethanol-induced liver injury in mice: Journal of nutritional diseases,2013 September;8(10):765-772. 
50. Bala S, Petrasek J, Mundkur S, et al. Circulating microRNAs in exosomes indicate hepatocyte injury and inflammation in alcoholic, drug-induced, and inflammatory liver diseases: 2012 Nov;56(5):1946–1957.
51. Dippold RP, Vadigepalli R, Gonye GE, Patra B, Hoek JB. Chronic ethanol feeding alters miRNA expression dynamics during liver regeneration:Alcoholism, clinical and experimental research. 2013 Jan;37(1):59–69.
52. Czaja MJ, Ding WX, Donohue TM, Jr., et al. Functions of autophagy in normal and diseased liver:Journal of Autophagy,2013 Aug;9(8):1131–1158. 
53. Ronis MJ, Mercer KE, Gannon B, et al. Increased 4-hydroxynonenal protein adducts in male GSTA4-4/PPAR-alpha double knockout mice enhance injury during early stages of alcoholic liver disease.:American journal of physiology. Gastrointestinal and liver physiology. 2015 Mar 1;308(5):403–415.
54. Ding WX. Induction of autophagy, a promising approach for treating liver injury. 2014 Jan;59(1):340–343. 
55. Hernandez-Gea V, Ghiassi-Nejad Z, Rozenfeld R, et al. Autophagy releases lipid that promotes fibrogenesis by activated hepatic stellate cells in mice and in human tissues: Journal of  Gastroenterology,2012 Apr;142(4):938–946
56. Ni HM, Du K, You M, Ding WX. Critical role of FoxO3a in alcohol-induced autophagy and hepatotoxicity: The American journal of pathology,2013 Dec;183(6):1815–1825. 
57. Tumurbaatar B, Tikhanovich I, Li Z, et al. Hepatitis C and alcohol exacerbate liver injury by suppression of FOXO3:The American journal of pathology. 2013 Dec;183(6):1803–1814. 
58. Tikhanovich I, Kuravi S, Campbell RV, et al. Regulation of FOXO3 by phosphorylation and methylation in hepatitis C virus infection and alcohol exposure. Journal of Hepatology,2014 Jan;59(1):58–70.
59. Whitfield JB, Masson S, Liangpunsakul S, Hyman J, Mueller S, Evaluation of laboratory tests for cirrhosis and for alcohol use, in the context of alcoholic cirrhosis: Journal of Alcohol Abuse .2018 Feb;66:1-7.
60. Current medical diagnosis and treatment 2014: Chapter 16. Liver, Biliary Tract, & Pancreas Disorders.
61. Schiff's diseases of the liver 11th ed.
62. Pugh RN, Murray-Lyon IM, Dawson JL, Pietroni MC, Williams R "Transection of the oesophagus for  bleeding oesophageal varices": Journal of Gastroenterology,1973 March;44 (2): 646–9.
63. Patch D, Armonis A, Sabin C, et al. (1999). "Single portal pressure measurement predicts survival in cirrhotic patients with recent bleeding". Journal of Gastroenterology,1999 March 60 (8): 264–9. 

64. Maddrey WC, Boitnott JK, Bedine MS, Weber FL, Jr, Mezey E, White RI: Jr Corticosteroid therapy of alcoholic hepatitis & Gastroenterology,1978 October;75:193–199. 
65. Akriviadis E, Botla R, Briggs W, Han S, Reynolds T, Shakil O. Pentoxifylline improves short-term survival in severe acute alcoholic hepatitis: a double-blind, placebo-controlled trial: Journal of Gastroenterology,2000;13(4):1637–1648. 
66. Ramond M-J, Poynard T, Rueff B, Mathurin P, Theodore C, Chaput J-C, et al. A randomized trial of prednisolone in patients with severe alcoholic hepatitis: New England Journal of Medicine,1992 December;326:507–512. 
67. Mathurin P, Mendenhall CL, Carithers RL, Ramond MJ, Maddrey WC, Garstide P, et al. Corticosteroids improve short-term survival in patients with severe alcoholic hepatitis (AH): individual data analysis of the last three randomized placebo controlled double blind trials of corticosteroids in severe AH: Journal of Hepatology,2002;36:480–487.
68. Helman RA, Temko MH, Nye SW, Fallon HJ. Alcoholic hepatitis: natural history and evaluation of prednisolone therapy. Ann Intern Med. 1971;74:311–321. 14. Depew W, Boyer T, Omata M, Redeker A, Reynolds T. Double-blind controlled trial of prednisolone therapy in patients with severe acute alcoholic hepatitis and spontaneous encephalopathy: Journal of  Gastroenterology,1980 December;78:524–529. 
69. Powell WJ, Klatskin G. Duration and survival in patients with Laennec's cirrhosis. Influence of alcohol withdrawal, and possible effects of recent changes in general management of the disease: American Journal Medicine,1968 Feb;44:406–420. 
70. Merkel C, Marchesini G, Fabbri A, Bianco S, Bianchi G, Enzo E, et al. The course of galactose elimination capacity in patients with alcoholic cirrhosis: possible use as a surrogate marker for death: Journal of Hepatology,1996;24:820–823. 
71. Lieber CS, Weiss DG, Groszmann R, Paronetto F, Schenker S. I. Veterans Affairs Cooperative Study of polyenylphosphatidylcholine in alcoholic liver disease: effects on drinking behavior by nurse/physician teams: Alcohol Clin Exp Res. 2003;27:1757–1764. 
72. Mendenhall CL, Roselle GA, Gartside P, Moritz T. Relationship of protein calorie malnutrition to alcoholic liver disease: a reexamination of data from two Veterans Administration Cooperative Studies: Alcohol Clin Exp Res. 1995;19:635–641. 
73. Mendenhall CL, Anderson S, Weesner RE, Goldberg SJ, Crolic KA. Protein-calorie malnutrition associated with alcoholic hepatitis. Veterans Administration Cooperative Study Group on Alcoholic Hepatiti: American Journal Medicine,1984;76:211–222.
74. Carithers RL, Jr, Herlong HF, Diehl AM, Shaw EW, Combes B, Fallon HJ, et al. Methylprednisolone therapy in patients with severe alcoholic hepatitis: a randomized multicenter trial: Journal of Annual Intern Medicine,1989;110:685–690.
75. Mendenhall CL, Roselle GA, Gartside P, Moritz T. Relationship of protein calorie malnutrition to alcoholic liver disease: a reexamination of data from two Veterans Administration Cooperative Studies: Alcohol Clin Exp Res. 1995;19:635–641. 
76. Patek AJ, Post J, Ralnoff OD. Dietary treatment of cirrhosis of the liver: JAMA, 1948;139:543–549.
77. Hirsch S, Bunout D, de la Maza P, Iturriaga H, Petermann M, Icazar G, et al. Controlled trial on nutrition supplementation in outpatients with symptomatic alcoholic cirrhosis: Journal of Parenter Enteral Nutrition 1993;17:119–124. 
78. Hirsch S, de la Maza MP, Gattas V, Barrera G, Petermann M, Gotteland M, et al. Nutritional support in alcoholic cirrhotic patients improves host defenses: Journal of American College of  Nutrition,1999;18:434–441. 
79. Kearns PJ, Young H, Garcia G. Accelerated improvement of alcoholic liver disease with enteral nutrition: Journal of  Gastroenterology,1992;102:200–205. 
80. Akriviadis E, Botla R, Briggs W, Han S, Reynolds T, Shakil O. Pentoxifylline improves short-term survival in severe acute alcoholic hepatitis: a double-blind, placebo-controlled trial: Journal of  Gastroenterology,2000;119:1637–1648.
81. Akerman PA, Cote PM, Yang SQ, McClain C, Nelson S, Bagby G, et al. Long-term ethanol consumption alters the hepatic response to the regenerative effects of tumor necrosis factor-alpha: Journal of Hepatology,1993;17:1066–1073. 
82. Tilg H, Jalan R, Kaser A, Davies NA, Offner FA, Hodges SJ, et al. Anti-tumor necrosis factor-alpha monoclonal antibody therapy in severe alcoholic hepatitis: Journal of Hepatology,2003;38:419–425. 
83. Menon KV, Stadheim L, Kamath PS, Wiesner RH, Gores GJ, Peine CJ, et al. A pilot study of the safety and tolerability of etanercept in patients with alcoholic hepatitis.:Am J Gastroenterol. 2004;99:255–260.
84. Roberts MS, Angus DC, Bryce CL, Valenta Z, Weissfeld L. Survival after liver transplantation in the United States: a disease-specific analysis of the UNOS database: Liver Transpl. 2004;10:886–897.
85. Farges O, Saliba F, Farhamant H, Samuel D, Bismuth A, Reynes M, et al. Incidence of rejection and infection after liver transplantation as a function of the primary disease: possible influence of alcohol and polyclonal immunoglobulin: 1996;23:240–248. 
86. Pageaux GP, Bismuth M, Perney P, Costes V, Jaber S, Possoz P, et al. Alcohol relapse after liver transplantation for alcoholic liver disease: does it matter?: J Hepatol. 2003;38:629–634. 
87. Buis CI, Wiesner RH, Krom RA, Kremers WK, Wijdicks EF. Acute confusional state following liver transplantation for alcoholic liver disease: Journal of 2002;59:601–605.
88. John Feehally, Jurgen Floege, Marcello Tonelli 6^th edition of Comprehensive Clinical Nephrology. 
89. Bellamy CO, DiMartini AM, Ruppert K, Jain A, Dodson F, Torbenson M, et al. Liver transplantation for alcoholic cirrhosis: long term follow-up and impact of disease recurrence: Journal of Liver Transplantation,2001;72:619–626.
90. Wong F, Reddy KR, O'Leary JG et al. Impact of Chronic Kidney Disease on Outcomes in Cirrhosis: Journal of Liver Transpl.2019 Jun;25(6):870-880.
91. Ramesh kumar Chronic Kidney Disease in Patients with Liver Cirrhosis: Diagnostic Precision Matter , article has been accepted and waiting for publication.

92. Sprawls P. Physical principles of medical imaging. Aspen Pub. ISBN:083420309X.
93. Bushberg JT, Seibert JA, Jr. EML et-al. The Essential Physics of Medical Imaging. LWW. ISBN:0781780578.https://radiopaedia.org/articles/chronic-kidney-disease?lang=us.
94. Lee WC, Lin HC, Hou MC, Lin HY, Lee FY, Wang SS, Chang FY et al Serum uric acid levels in patients with cirrhosis:a reevaluation J Clin Gastroenterol. 1999 Oct;29(3):2615.
95. Asrani SK, Devarbhavi H, Eaton J, Kamath PS Burden of liver diseases in the world J Hepatol. 2019 Jan;70(1):151-171.
96. Liver cirrhosis Wikipedia.
97. National Kidney Foundation (2002). “K/DOQI clinical practice guidelines for chronic kidney disease" Archived from the original on 2005-04-15. Retrieved 2008-06-29.

98. Maxime A, Papadakis MD, Allen I, Arieff Unpredictability of clinical evaluation of renal function in cirrhosis:American Journal of Medicine,1987 January 2;12(5):945-952.
99. Cardenas A, Arroyo V.Renal and circulatory dysfunction in liver cirrhosis: Pathogenesis and treatment: Annals of Gastroenterology 2001;14(3):212-221.
100. Florence W. Liver and Kidney diseases. Clin Liver Dis.2002 Nov;6( 4):981-991.
101. Cholongitas E, Shusang V, Marelli I, Nair D,Thomas M, Patch D .Alimentary Pharmacology & Therapeutics: Journal of Gstroenterology,2007 Oct; 26(7):969-978.
102. Lee JW. Renal Dysfunction in Patients with Chronic Liver Disease. Electrolytes  Blood Pressure: Journal of Renal Dysfunction,2009 August;7(42):301-306.
103. N. Renal Dysfunction and Liver Transplantation. Liver Transplantation - Technical Issues and Complications : International Journal of liver Transplantation,2012 September;4(1): 978-953
104. Pipili C, Cholongitas E. Renal dysfunction in patients with cirrhosis: Where do we stand? World J Gastrointest Pharmacol Ther. 2014 Aug 6; 5(3): 156–168.
105. Aggarwal HK, Jain D, Singla SK. Assessment of Renal Functions in Patients of Cirrhosis. Journal of Clinical and Experimental Hepatology 2015 june-july, supplement 2:30-31.
106. Haesuk Park et al Nonalcoholic fatty liver disease increases risk of incident advanced chronic kidney disease: a propensity‐matched cohort study: Journal Of Internal Medicine 2019 july 29;6(2):234-241.

107. Morgan Marcuccilli and Michel Chonchol NAFLD Chronic Kidney Disease: International Journal of Molecular Sciences 2016 Apr; 17(4): 562.
108. Hye Ryoun Jang, Danbee Kang,et al Nonalcoholic fatty liver disease accelerates kidney function decline in patients with chronic kidney disease: a cohort study: US National Library of Medicine 2018 Mar 16; 8: 4718.
109. Chinnadurai R, Ritchie J, Green D, Kalra PA Non-alcoholic fatty liver disease and clinical outcomes in chronic kidney disease: Pubmed 2019 Mar 1;34(3):449-457.
110. Akash Rajender, et al Association of non-alcoholic fatty liver disease with chronic kidney disease in type 2 diabetes mellitus: International Journal of Research In Medical Sciences, 2019 Oct; 26(7):969-978.
111. Sinn DH, et al Chronic kidney disease risk increases with NAFLD severity: Journal Of Hepatology 2017 September 6;31(2):499-517.

112. Giovanni Targher et al Increased Risk of CKD among Type 2 Diabetics with Nonalcoholic Fatty Liver Disease: European Journal of Medicine 2008 August;19 (8):1564-1570.
113. Giovanni Targher et al CKD and Nonalcoholic Fatty Liver Disease: American journal of kidney diseases, 2014 October; 64(4):638-652.
114. Po-ChunChen et al The correlation between fatty liver disease and chronic kidney disease: Journal of the Formosan Medical Association 2019 March 12;3(1):411-415.

115. Kan Sun et al Fatty liver index, albuminuria and the association with chronic kidney disease: a population-based study in China: BMJ Open 2017 September; 8(1):234-240
116. Ram V. Nampoothiri Renal Dysfunction in Patients With Nonalcoholic Fatty Liver Disease is Related to the Presence of Diabetes Mellitus and Severity of Liver Disease: Journal of Clinical and Experimental Hepatology, 2019 January – February;9,(1):22-28.
117. Guolin Li et al Nonalcoholic fatty liver associated with impairment of kidney function in nondiabetes population: Biochemia Medica. 2012 February15,22(1): 92 – 99.
118. Clara E et al Coming Complications of Nonalcoholic Fatty Liver Disease: Journal of Digestive Diseases and Sciences, 2019 March; 64(3):606-608.
119. Serum uric acid and non-alcoholic fatty liver disease in non-obesity Chinese adults: Lipids in Health and Disease volume16, Article number: 202 (2017) .
120. Anita Afzaliet al Association between serum uric acid level and chronic liver disease in the United States: Journal of Hepatology; 2010 July 23;52 (2):578-589.

Dr Subhadip Paul

Post Graduate Trainee, Department of General Medicine, AGMC & G.B. Pant Hospital, Agartala