Correlation between nonalcoholic fatty liver and cardiovascular disease in elderly hemodialysis patients

Abstract

The number of elderly patients with end-stage kidney disease is on the rise. Nonalcoholic fatty liver disease (NAFLD) is characterized by parenchymal fat accumulation in patients without information about alcohol abuse. The aim of our study was to determine correlation between NAFLD and cardiovascular diseases in elderly hemodialysis patients. The examination was organized as observational and cross-sectional study in elderly patients on hemodialysis. An abdominal ultrasound examination was made in order to define NAFLD. Intima-media thickness of the carotid arteries was quantified by Doppler ultrasound. Biochemical parameters, gender, anthropometric characteristics, duration, adequacy of hemodialysis, blood pressure, smoking and cardiovascular disease were determined. Respondents were divided into a group with NAFLD (37/72 patients, 51%) and group without NAFLD (35/72 patients, 49%). Patients with NAFLD have significantly more cardiovascular disease (p=0.017) as well as significantly higher values of intima-media thickness of the carotid arteries (p=0.03) in correlation with patients without NAFLD. Patients without NAFLD have a statistically lower triglyceride (p=0.04), aspartate aminotransferase (p=0.006), alanine aminotransferase (p=0.013) and gamma-glutamyl transpeptidase (p=0.029) compared to patients with NAFLD. Patients with cardiovascular disease have a higher risk of NAFLD; likewise, patients with NAFLD have a three times higher chance for developing cardiovascular diseases (OR 3.01). Elderly patients on hemodialysis with cardiovascular disease have a higher risk of NAFLD; likewise, patients with NAFLD have a three times higher chance for developing cardiovascular diseases.