#4659 PREVALENCE OF LIVER STEATOSIS MEASURED BY MULTIFREQUENCY BIOIMPEDANCE IN PATIENTS WITH CKD

Abstract

Abstract Background and Aims The increase in visceral fat is one of the factors that contribute to the increased cardiovascular risk associated with CKD. There are few data on the prevalence of hepatic steatosis in patients with CKD. The Maltron multifrequency BIA offers us the possibility of evaluating it. The purpose of this study was to determine the prevalence of hepatic steatosis by means of multifrequency bioimpedance and to correlate it with its presence by ultrasound or CT in patients with CKD on Advanced CKD(ACKD) and HD. Methods We carried out a study of body composition with BIA in 315 patients, analyzing with the Maltron monitor Bioscan i-touch8 the determination of hepatic steatosis and its classification into 4 stages of involvement (normal, mild, moderate, moderately-severe and severe steatosis. We also correlated with ultrasound studies that had In order to see coincidence, we also obtained data from 9 patients without CKD.We established global steatosis prevalence and in CKD and HD and correlated with GOT,GPT,GGT,MIS, waist/height ratio, mass-fat and BMI. Results 315 patients evaluated for CKD 151 (48%) and HD 163 (52%), 67.9% men aged 70.79 ± 12.87 years (sig difference between CKD and HD (72.4 ± 2.7) vs 69.2 ±14.3) p0.023. Globally we found healthy liver in 37.9% and steatosis in 61.3% appearing mild-13.4%, moderate 11.8%, light-high 11.4% and high 24.5%. We observed healthy liver in 35.1% in ACKD vs 40.5% in HD. We did not find significant differences between liver enzyme values between healthy liver and steatosis at a global level. We established correlation/coincidence between ultrasound/CT and BIA in 72 patients. We found a healthy liver BIA-ECHO correlation in 43 cases (93.4%), steatosis by BIA coincides with ECHO in 41.6%. If we combine healthy liver + mild steatosis by BIA, the BIA-Echo healthy liver coincides in 92.7% and steatosis in 50%. Establishing cut-off points for BMI, % fat mass and waist/height index using COR curves, we obtain areas-under-the-curve 0.828, 0.738 and 0.853 respectively, being Waist-height index (WC 0.6) with better sensitivity 80% and specificity 71, 3%. If we determine the area of fat mass with another tool, we see AUC 0.838 with 72.3% specificity and 91.3% sensitivity to detect normal liver. Conclusion 1) A high prevalence of hepatic steatosis due to IAB appears in patients with CKD greater in CKD than in HD. 2) There is a good correlation with ECO for a healthy liver and there are parameters that correlate well in a healthy liver diagnosis. 3) Specific studies of Ultrasound-BIA are needed to validate the diagnosis of steatosis.