engleski

Nonalcoholic fatty liver disease - a new cardiovascular risk factor in elderly haemodialysis patients

We were interested to explore the association of nonalcoholic fatty liver disease (NAFLD) and cardiovascular disease (CVD) risk in elderly hemodialysis (HD) patients. We have been analyzed 80 patients that are ≥65 years of age and were treated with chronic HD for at least 6 months. The controlled attenuation parameter (CAP) was used to detect and quantify liver steatosis with the help of transient elastography (TE). In all patients, a carotid ultrasound was performed to investigate the association of NAFLD with carotid intima-media thickness (ITM) and plaque as surrogate measures of increased cardiovascular risk. Elderly HD patients with NAFLD showed more carotid atherosclerosis in comparison with elderly HD patients without NAFLD. Elderly HD/NAFLD patients had the mean ITM of 1.1±0.1 mm and that was statistically significant higher than the mean ITM measurements founded in elderly HD patients without NAFLD (1.1±0.1vs.0.9±0.2 mm ; p<0.0001). Furthermore, elderly HD patients with NAFLD had statistically significant higher prevalence of plaques in comparison with elderly HD patients without NAFLD (71.7%vs.47.1% ; p=0.037). Moreover, there was a significant, positive, correlation between CAP and ITM measurements (r=0.4222 ; p=0.0001). In multivariate analysis, high CRP and presence of NAFLD were found to be independent predictors of carotid atherosclerosis. Physicians who manage elderly HD patients’ shouldn´t only focus on dialysis procedure but should also recognize other conditions such as NAFLD. Early recognition of NAFLD may recognize high-risk elderly HD patients that will develop adverse CVD events. Further studies that will investigate these observations in elderly hemodialysis patients are needed.

nonalcoholic fatty liver disease; elderly patients

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