engleski

Nonalcoholic fatty liver disease and renin-angiotensin-aldosteron system blockers in chronic kidney disease patients - is there a link?

Recent data suggest that the renin-angiotensin-aldosteron system (RAAS) may be of importance in the pathogenesis of Nonalcoholic fatty liver disease (NAFLD). We were interested to investigate whether the therapy with RAAS blockers in patients with different stages of CKD has any effect on steatosis and fibrosis grade ; NAFLD documented by transient elastography (TE). Of 191 patients there were 61 patients with CKD grade III and IV, 62 patients with End-Stage renal disease treated with chronic haemodialysis and 68 renal transplant recipients. We didn’t found statistically significant difference in the CAP values, although CKD-NAFLD patients who didn’t received ACE-I/ARBs had higher frequency of steatosis grade III and lower frequency of steatosis grade I. CKD patients (p=0.005) and CKD-NAFLD patients (p=0.0005) with ACE-I or ARBs had statistically significant lower degree of liver stiffness (fibrosis) in comparison to those without these medications (p=0.005). Furthermore, analyzing the various laboratory parameters between two subgroups of patients, we found that CKD-NAFLD patients who took ACE-I or ARBs had statistically significant higher values of hemoglobin levels (p=0.0001) and statistically significant lower values of CRP (p=0.0014) and feritin (p=0.0004) in comparison to those CKD-NAFLD patients who didn’t take these medications. RAAS blockers could be an attractive option for the management of NAFLD in CKD patients.

NAFLD; RAAS inhibitors; CKD

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