engleski

Nonalcoholic fatty liver disease – a new marker of malnutrition, inflammation and atherosclerosis in haemodialysis patients?

In contrast to general population where over-nutrition or obesity is associated with increased cardiovascular (CVD) risk, in patients that are on maintained haemodialysis (HD) malnutrition is associated with poor outcome. In general population, nonalcoholic fatty liver disease (NAFLD) is associated with obesity, hypertension, dislipidemya and type-2 diabetes. There is growing evidence that NAFLD is strongly associated with CVD. Preliminary data suggest an association between chronic kidney disease and NAFLD. Ninthly-four HD patients were followed for a minimum of 18 months or until death. The primary endpoint of this study was to determine the patient’s survival due to nutritional and inflammatory state and the presence or absence of NAFLD. The second endpoint of this analysis was to investigate the association among NAFLD and various clinical and laboratory data regarding nutritional and inflammatory state of our patients. We did not find any significant association among the clinical parameters of nutritional status and mortality rate. The mortality rate was statistically significantly higher in patients with low serum albumin and high hs-CRP levels and also in those who had NAFLD. We were surprised not to find a better survival rate in those patients who had received enteral nutrition. The severity of liver steatosis was negatively correlated with the serum albumin levels, while it was positively correlated with hs-CRP values. Furthermore, serum albumin levels showed a negative correlation with hs-CRP levels. On the other hand, we didn’t find any significant association between the presence of NAFLD values and clinical parameters of nutrition. We have shown for the first time that NAFLD could be one more possible example of reverse epidemiology in dialysis patients. Furthermore, we have shown that NAFLD could be a new factor that contributes to type two of malnutrition in dialysis population.

dialysis; nutritional status; nonalcoholic fatty liver disease; cardiovascular risk

nije evidentirano