INTENSITY OF THE ANTIOXIDANT PROTECTION SYSTEM AND OXIDATIVE STRESS FACTORS IN PATIENTS WITH NON-ALCOHOLIC STEATOHEPATITIS DEPENDING ON THE FORM OF CHRONIC KIDNEY DISEASE.

The article presents a theoretical generalization of the research results the intensity of the antioxidant protection system and oxidative stress factors in patients with non-alcoholic steatohepatitis depending on the form of chronic kidney disease. The objective of the article - determining the pathogenetic role of the processes of antioxidant protection system in the development and interconnection mechanisms of non-alcoholic steatohepatitis (NASH) and obesity depending on the form and stage of chronic kidney disease (CKD). 177 patients were examined for this purpose, including: 35 patients with NASH with concomitant obesity of І-ІІ degree (1st group), 36 patients with NASH with accompanying obesity of І-ІІ degree and CKD І-ІІ stage: Chronic bilateral pyelonephritis in the phase of exacerbation (2A group), 35 patients with NASH on the background of obesity I-II st. with CKD of the 3rd stage: Chronic bilateral peyelonephritis, exacerbation (2B group), 37 patients with NASH with obesity I-II stage and gouty nephropathy (group 3), 34 patients with NASH, which developed on the background of obesity I-II stages that developed from asymptomatic hyperuricemia (AHU) (group 4). The control group consisted of 30 practically healthy persons (PHP). For the comorbidity of NASH from CKD of the I-III stages. In the form of chronic pyelonephritis, the intensity of oxidative stress increases: the accumulation of intermediate (isolated double bonds, diene conjugates) and terminal (malonic aldehyde, ketodienes and conjugated triines) products of lipids peroxide oxidation, oxidation proteins modification (aldehyde and ketone dinitrophenyl hydrazones of the main and neutral) against the background of the disintegration of the activity of antiradical protection factors (reduction of content in erythrocytes of recovered glutathione, activity of superoxide dismutase, the growth of catalase activity, glutathion-dependent enzymes). Due to the comorbidity of non-alcoholic steatohepatitis with gouty nephropathy and in conditions of asymptomatic hyperuricemia, the degree of oxidative stress is significantly lower due to the strong antioxidant properties of uric acid, but the degree of endotoxicosis predominates in steatohepatitis without kidney damage. The uncontrolled intensification of the processes of free radical oxidation of lipids and proteins in patients with non-alcoholic steatohepatitis that developed on the background of obesity and CKD I-III stages, determines the degree of pathological process activity in the liver and the degree of endotoxicosis.