Authors
1
Department of internal medicine -Nephrology unite, Faculty of Medicine, Ain Shams University, Cairo 11566, Egypt
2
Department of internal medicine -Nephrology unite,Faculty of Medicine, Ain Shams University, Cairo 11566, Egypt
3
Department of Internal Medicine- Gastroenterology and Hepatology unite, Faculty of Medicine, Ain Shams University, Cairo 11566, Egypt
Abstract
This study evaluated the hypothesis of a possible association between hyperparathyroidism
and the presence of hepatic steatosis and fibrosis among prevalent hemodialysis (HD) patients
and evaluated the possible risk factors of non-alcoholic fatty liver disease (NAFLD) among
those patients. This is a case-control study that included HD patients divided into GI: (30) HD
patients with NAFLD, GII: (25) HD patients without NAFLD as well as GIII: (30) healthy
volunteers as a control. Viral hepatitis, Diabetes mellitus, recent hepatobiliary surgery, ascites,
active infection, malignancy, alcohol, or drugs induce hepatic steatosis were excluded. Complete
blood count, Iron profile, lipid profile, liver function tests, C- reactive protein (CRP) titer,
intact parathyroid hormone (iPTH), and other routine chemistry tests were done. Transient
elastography Fibroscan® to assess controlled attenuation parameter (CAP) to detect liver steatosis
grades and liver stiffness measurement was done.
Results: Mean ±SD values of CAP of liver steatosis (263.7±52.7, 181.3±23, 210.8±33.7)
(dB/m) in GI, GII & control group respectively (P <0.001). Post-Hoc analysis revealed a significant
statistical difference between G I and II as regards ALT, AST, Bilirubin level and serum
albumin, CRP titer, and lipid profile. In HD patients' studied groups, the CAP value of
liver steatosis was significantly correlated to BMI, ALT, AST, Cholesterol, LDL, TG, & CRP
Titer, but not correlated to PTH or other parameters. In GIII, there was a significant correlation
between the measured CAP value of liver steatosis and BMI, iPTH, CRP titer, ALT, AST,
cholesterol, LDL, and a negative correlation between HDL and CAP value. Liver stiffness/
fibrosis was in 18 (60.0%), HD patients versus 8 (32%) patients in GII. Analysis showed
a significant difference between GI & GII and between GI and GIII regarding the presence of
liver fibrosis
Keywords
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