#2779 THROMBOMODULIN IS A SPECIFIC MARKER OF ENDOTHELIAL DYSFUNCTION IN HEMODIALYSIS PATIENTS WITH NON-ALCOHOLIC FATTY LIVER DISEASE

Abstract

Abstract Background and Aims Non-alcoholic fatty liver disease (NAFLD) is associated with endothelial dysfunction which is a common problem in hemodialysis patients and a risk for high cardiovascular mortality in hemodialysis. Thrombomodulin is a promising marker of endothelial cell injury in different pathological conditions. This study evaluates the additive effect of non-alcoholic fatty liver disease (NAFLD) in prevalent HD patients on endothelial dysfunction. Methods A case-control study was conducted on 60 end-stage renal disease (ESRD) patients on conventional hemodialysis: group A: 30 patients with NAFLD, group B: 30 patients without NAFLD, and control group of 30 apparently healthy subjects. Excluding elderly, diabetic patients, chronic Liver disease, advanced heart Failure, active infection, COVID-19 infection, autoimmune diseases and patients with hemodialysis catheters. Thrombomodulin was measured for all participants by ELISA technique. Results Thrombomodulin could detect endothelial dysfunction in patients with NAFLD at Cut off value <0.8 ng/ml with sensitivity 53.33%, specificity 80%, PPV 72.7%, and NPV 63.2%. On comparing Thrombomodulin in patients with NAFLD (4.378±3.762 ng/ml), Non-NAFLD (1.126±0.591 ng/ml), and control (0.755±0.314 ng/ml) there was a significant difference (P-value<0.001). Post hoc analysis showed significantly high Thrombomodulin levels in patients with {NAFLD versus Non-NAFLD} and {NAFLD versus control} with p-value<0.001, 0.001 respectively while there was no significant difference between patients with Non-NAFLD and control p-value 0.792. NAFLD patients with positive thrombomodulin have a risk of 2.5 times having endothelial dysfunction. There was no significant correlation between Thrombomodulin and all variables in the study. Conclusions Thrombomodulin can be used as specific marker for endothelial dysfunction in hemodialysis patients with Non Alcoholic fatty liver disease.