engleski

Relationship between nonalcoholic fatty liver disease and mia syndrome

Nonalcoholic fatty liver disease (NAFLD) is an important factor in the pathogenesis of cardiovascular diseases in general population. Recently, it has been shown that NAFLD is highly prevalent in chronic kidney disease (CKD) patients. Ninety-four haemodialysis (HD) patients were followed for a time period of 18 months or until death. Patient’s survival rate was determined in relation to their nutritional and inflammatory state and the presence of NAFLD. We also investigated the association between the presence of NAFLD and the patients’ nutritional and inflammatory state. We did not find any significant association between the clinical parameters of nutritional status and the mortality rate. However, the mortality rate was statistically significantly higher in patients with low serum albumin and high hs-CRP levels and in those who had NAFLD. Surprisingly, patients who had received enteral nutrition did not have a better survival rate. 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. We did not find any significant association between the presence of NAFLD and clinical parameters of nutrition. We have shown that NAFLD could be one more possible example of reverse epidemiology in HD patients. NAFLD may be the missing link that causally ties MIA syndrome to the morbidity and mortality in HD patients.

haemodialysis; non-alcoholic fatty liver disease; malnutrition; mortality

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