• Javed Anwar Combined Military Hospital, Multan
  • Muhammad Omer Aamir Combined Military Hospital, Multan
  • Sanaullah Sanaullah Combined Military Hospital, Multan
  • Zeeshan ul Hasnain Imdad Combined Military Hospital, Multan
  • Ishrat Parveen Combined Military Hospital, Multan
  • Nasreen Yousaf Combined Military Hospital, Multan


Background: Diabetes mellitus is a common disease. Similarly, ultrasound findings of fatty change and renal crystals are commonly seen on ultrasound. In the personal observation of the main author over the past so many years it was noticed that Diabetes Mellitus, Fatty liver and renal crystals all sit well together. This study tries to establish a relationship between diabetes mellitus renal echogenic foci and fatty liver. This study is first of its kind, as nobody has ever before investigated an association between the renal echogenic foci and fatty liver in relation to diabetes mellitus. Methods: This cross-sectional, observational study was conducted at Radiology Department Combined Military Hospital, Kohat From 2nd June 2013 to 30th May 2014. Three hundred patients were collected on the basis of having fatty liver and renal echogenic foci on ultrasound and three hundred more patients were collected who had no fatty liver or renal echogenic foci on ultrasound. Their labs were done for diabetes mellitus.  Results: The patients having renal echogenic foci together with fatty liver had 83% positive rate of being diabetics, while patients with no fatty liver and no echogenic foci on ultrasonography had only 0.6% Positive rate of being diabetics. Conclusion: Our results provided the first demonstration of an association between renal echogenic foci together with fatty liver with the diabetes mellitus. Thus ultrasound examination of abdomen can be helpful in its early diagnosis if we make a protocol of doing fasting and random blood sugars in all those patients who have positive renal echogenic foci and fatty liver on their ultrasound examination.


Cazzo E, de Felice Gallo F, Pareja JC, Chaim EA. Nonalcoholic fatty liver disease in morbidly obese subjects: correlation among histopathologic findings, biochemical features, and ultrasound evaluation. Obes Surg 2014;24(4)47–61.

Lv WS, Sun RX, Gao YY, Wen JP, Pan RF, Li L, et al. Nonalcoholic fatty liver disease and microvascular complications in type 2 diabetes. World J Gastroenterol 2013;19(20):3134–42.

Levinthal GN, Tavill AS. Liver disease and diabetes mellitus. Clin Diabetes. 1999;17(2):73–93.

Rodriguez-de-Velasquez A, Yoder IC, Velasquez PA, Papanicolaou N. Imaging the effects of diabetes on the genitourinary system. Radiographics 1995;15(5):1051–68.

Chi T, Miller J, Stoller ML. Randall plaque versus renal stone? Transl Androl Urol 2012;1:66–70.

Klouwens MJ, Blok WL, Witmer AN, Verouden CJ, Mura M. Serious complications of urinary tract infection in diabetes: emphysematous pyelonephritis and endogenous endophthalmitis. Ned Tijdschr Geneeskd 2013;157(7):A5243.

Carpentier X, Bazin D, Jungers P, Reguer S, Thiaudière D, Daudon M. The pathogenesis of Randall's plaque: a papilla cartography of Ca compounds through an ex vivo investigation based on XANES spectroscopy. J Synchrotron Radit 2010;17(3):374–9.

Ciftçioğlu N, Vejdani K, Lee O, Mathew G, Aho KM, Kajander EO, et al. Association between Randall's plaque and calcifying nanoparticles. Int J Nanomedicine 2008;3(1):105–15.

Brenner DJ, Hall EJ. Computed tomography--an increasing source of radiation exposure. N Engl J Med 2007;357(22):2277–84.

Evan AP, Coe FL, Lingeman JE, Worcester E. Insights on the pathology of kidney stone formation. Urol Res 2005;33(5):383–9.

Williams JC Jr, Matlaga BR, Kim SC, Jackson ME, Sommer AJ, McAteer JA, et al. Calcium oxalate calculi found attached to the renal papilla: Preliminary evidence for early mechanisms in stone formation. J Endourol 2006;20(11):885–90.