engleski

Fibroscan in Detection of Non-alcoholic Fatty Liver Disease in Patients on Peritoneal Dialysis - a Pilot Study

Continuous ambulatory peritoneal dialysis (CAPD) is associated with a number of metabolic abnormalities. Among others, lipid and carbohydrate abnormalities as well as constant albumin and amino acid losses can lead to non-alcoholic fatty liver disease (NAFLD). AIMS & The aim of this study was to investigate whether patients with end-stage renal disease (ESRD) on CAPD had increased tendency to NAFLD and to analyze whether dialysate composition, lipid profile, duration of CAPD and comorbidities play a role in NAFLD occurrence. We studied 22 patients of CAPD (F10:M12) with a mean age of 58.8 ± 12.9 (26-78) years. No patient was hepatitis B and anti-hepatitis C virus positive and none had history of alcohol abuse. In all patients, BMI, mean glucose concentration in dialysate, serum fasting glucose, AST, ALT, cholesterol, triglyceride, albumin and CRP were measured. Fibroscan (Echosenc) was performed in all patients in order to detect and quantify liver steatosis and fibrosis. The cut-off value for defining liver steatosis was Controlled Attenuation Parameter ≥238 dB/m and for liver fibrosis the stiffness of >7 kPa. Dyslipidemia was found in 14 patients (63.63%) and seven patients (31.81%) had diabetes mellitus. Mean concentration of dialysate glucose was 1.41% ± 0.14 (1, 36-1, 81). The NAFLD was observed in 14 patients (63, 63%), and among them eight patients (57, 14%) had also liver fibrosis. All of diabetic patients had NAFLD whereas just 50% of ESRD patients with dyslipidemia had NAFLD. Interestingly, not statistically significant differences in all measured parameters between NAFLD positive and negative group of patients were observed. The severity of liver steatosis was positively correlated with serum fasting glucose (r=0, 516 ; p=0, 014) and BMI (r=0, 441 ; p=0, 40) and negatively correlated with haemoglobin (r=-0, 576 ; p=0, 005) and serum calcium level (r=-0, 448 ; p=0, 037). Our results showed that ESRD patients on CAPD have high prevalence of NAFLD. As far as we know this is the first study of Fibroscan using approach for NAFLD detection in ESRD patients on CAPD.

Continuous ambulatory peritoneal dialysis; Fibroscan; Non-alcoholic fatty liver disease

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