Can we predict the co-occurrence of nonalcoholic fatty liver disease and uric acid urolithiasis? Assessment of prevalence based on findings in preoperative computed tomography imaging

Marta Jankowska, Jakub Kalembkiewicz, Marek Miśkiewicz, Kamila Durmała, Aleksandra Słojewska, Krystian Kaczmarek, Marcin Słojewski

Abstract


Introduction: Observational studies have already shown an association between the co-occurrence of nonalcoholic fatty liver disease (NAFLD) and urinary tract stones. A plausible mechanism for their development is the increased consumption of high-fat foods and fructose syrup, which if consumed in excess, is metabolized to uric acid. Its excessive concentration in the urine lead to the development of urolithiasis. Therefore, it can be assumed that NAFLD will most often co-occur with uric acid stones. Hence, we aimed to evaluate the co-occurrence of both diseases based on findings in preoperative computed tomography (CT) imaging. 
Materials and methods: The study population included all consecutive patients with urinary tract stones who underwent surgical treatment between 2019–2022. A total of 228 patients were enrolled in this study and evaluated for the presence of strict exclusion criteria. After applying the exclusion criteria 124 patients undergoing surgical treatment of urolithiasis were included in the further analysis. 
Results: Uric acid deposits defined as stones with a density <500 HU were found in 12.90% of patients. Nonalcoholic fatty liver disease was diagnosed in 28 patients, as many as 42.86% of whom were diagnosed with uric acid stones (p < 0.001). A significant correlation was found between the incidence of both disease entities at 0.483 (Q-Yule coefficient). 
Conclusions: The presence of NAFLD in imaging studies is more often found in patients with uric acid stones. Therefore, diagnosis of co-occurrence of both conditions might allow the implementation of appropriate treatment without the need for chemical analysis of the deposit.

Keywords


nonalcoholic fatty liver disease; NAFLD; urolithiasis; urinary stone disease; uric acid stones; computed tomography imaging; metabolic syndrome

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References


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DOI: https://doi.org/10.21164/pomjlifesci.989

Copyright (c) 2025 Marta Jankowska, Jakub Kalembkiewicz, Marek Miśkiewicz, Kamila Durmała, Aleksandra Słojewska, Krystian Kaczmarek, Marcin Słojewski

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