engleski

Nonalcoholic fatty liver disease (NAFLD) - a new cardiovascular risk factor in peritoneal dialysis patients

Recent investigations indicated that nonalcoholic fatty liver disease (NAFLD), a hepatic component of metabolic syndrome, is associated with an increased risk of cardiovascular diseases (CVD). Accordingly, we were interested to explore the frequency of NAFLD in peritoneal dialysis (PD) patients and to analyze factors in PD patients associated with NAFLD occurrence. In addition, we were interested in investigating is NAFLD associated with higher CVD risk in our PD patients. In the present cross-sectional study, we analyzed 58 PD patients. The controlled attenuation parameter (CAP) was used to detect and quantify liver steatosis with the help of transient elastography (TE) (FibroScan®, Echosense SA, Paris, France). A carotid ultrasound was performed in all patients to measure carotid intima-media thickness (ITM) and plaque as surrogate measures of increased CVD risk and we investigated their association with NAFLD. NAFLD was present in 74.1% of PD patients. PD/NAFLD patients had statistically greater daily (136.5±62.6 vs 93.6±36.1 ; p=0.02) and monthly (4095.3±1877.7 vs. 2806.6±1083.2 ; p=0.02) glucose load in comparison to the non-NAFLD/PD patients. In the next step, we were interested to analyze what demographic and clinical characteristic in our PD patients are associated with a higher NAFLD occurrence. Presence of DM, AH, dyslipidemia, body mass index > 25 kg/m2, body mass index > 25 kg/m2 and daily glucose load > 100 g were associated with NAFLD occurrence. PD patients with NAFLD showed more carotid atherosclerosis than PD patients without NAFLD. In addition, CAP values (as indicator of liver steatosis) had shown strong positively association with IMT (r=0.801 ; p<0.0001). NAFLD was a strong predictor of carotid atherosclerosis in PD patients. NAFLD is highly prevalent in PD patients. PD patients with NAFLD are at high risk of atherosclerosis. Assessment of NAFLD in PD patients may be helpful for CVD risk stratification.

cardiovascular risk; peritoneal dialysis; nonalcoholic fatty liver disease

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