Skip to main content

Advertisement

SpringerLink
Log in

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

  • Nephrology - Original Paper
  • Published:
International Urology and Nephrology Aims and scope Submit manuscript

Abstract

Purpose

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.

Methods

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 %).

Results

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).

Conclusion

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.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Hamer RA, El Nahas AM (2006) The burden of chronic kidney disease. BMJ 332:563–564

    Article  PubMed  PubMed Central  Google Scholar 

  2. Jager KJ, van Dijk PC, Dekker FW, Stengel B, Simpson K, Briggs JD (2003) The epidemic of aging in renal replacement therapy: an update on elderly patients and their outcomes. Clin Nephrol 60:352–360

    Article  CAS  PubMed  Google Scholar 

  3. Kurella M, Covinsky KE, Collins AJ, Chertow GM (2007) Octogenarians and nonagenarians starting dialysis in the United States. Ann Intern Med 146:177–183

    Article  PubMed  Google Scholar 

  4. Dunn W, Xu R, Wingard DL, Rogers C, Angulo P, Younossi ZM et al (2008) Suspected nonalcoholic fatty liver disease and mortality risk in a population-based cohort study. Am J Gastroenterol 103:2263–2271

    Article  PubMed  PubMed Central  Google Scholar 

  5. Serfaty L, Lemoine M (2008) Definition and natural history of metabolic steatosis: clinical aspects of NAFLD, NASH and cirrhosis. Diabetes Metab 34:634–637

    Article  CAS  PubMed  Google Scholar 

  6. Vuppalanchi R, Chalasani N (2009) Nonalcoholic fatty liver disease and nonalcoholic steatohepatitis: selected practical issues in their evaluation and management. Hepatology 49:306–317

    Article  PubMed  PubMed Central  Google Scholar 

  7. Schreuder TC, Verwer BJ, van Nieuwkerk CM, Mulder CJ (2008) Nonalcoholic fatty liver disease: an overview of current insights in pathogenesis, diagnosis and treatment. World J Gastroenterol 14:2474–2486

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  8. Mohammadi A, Ghasemi-Rad M (2012) Evaluation of gastrointestinal injury in blunt abdominal trauma “FAST is not reliable”: the role of repeated ultrasonography. World J Emerg Surg. doi:10.1186/1749-7922-7-2

    PubMed  PubMed Central  Google Scholar 

  9. Targher G, Valbusa F, Bonapace S, Bertolini L, Zenari L, Rodella S et al (2013) Non-alcoholic fatty liver disease is associated with an increased incidence of atrial fibrillation in patients with type 2 diabetes. PLoS One 8(2):CD57183. doi:10.1371/journal.pone.0057183

    Article  Google Scholar 

  10. Neri S, Signorelli SS, Scuderi R, Bruno M, Bertino G, Clementi A et al (2011) Carotid intima-media thickness and liver histology in hemodialysis patients with nonalcoholic fatty liver disease. Int J Angiol 20:149–156

    Article  PubMed  PubMed Central  Google Scholar 

  11. Slack A, Yeoman A, Wendon J (2010) Renal dysfunction in chronic liver disease. Crit Care 14:214. http://ccforum.com/content/14/2/214. Accessed 23 June 2015

  12. Fracanzani AL, Burdick L, Raselli S, Pedotti P, Grigore L, Santorelli G et al (2008) Carotid artery intima-media thickness in nonalcoholic fatty liver disease. Am J Med 121:72–78

    Article  PubMed  Google Scholar 

  13. Friedewald WT, Levy RI, Fredrickson DS (1972) Estimation of the concentration of low-density lipoprotein cholesterol in plasma, without use of the preparative ultracentrifuge. Clin Chem 18:499–502

    CAS  PubMed  Google Scholar 

  14. Daugirdas JT (1994) Chronic haemodialysis prescription: a urea kinetics approach. In: Daugirdas J, Ing TS (eds) Handbook of dialysis. Little Brown, Boston, pp 92–120

    Google Scholar 

  15. Saadeh S, Younossi ZM, Remer EM, Gramlich T, Ong JP, Hurley M et al (2002) The utility of radiological imaging in nonalcoholic fatty liver disease. Gastroenterol 123:745–750

    Article  Google Scholar 

  16. Saverymuttu SH, Joseph AE, Maxwell JD (1986) Ultrasound scanning in the detection of hepatic fibrosis and steatosis. Br Med J (Clin Res Ed) 292:13–15

    Article  CAS  Google Scholar 

  17. Tahmasebpour HR, Buckley AR, Cooperberg PL, Fix CH (2005) Sonographic examination of the carotid arteries. Radiographics 25:1561–1575

    Article  PubMed  Google Scholar 

  18. Franco MRG, Fernandes NMS (2012) Dialysis in the elderly patient: a challenge of the XXI century narrative review. J Bras Nefrol 34:132–141

    Google Scholar 

  19. Sass DA, Chang P, Chopra KB (2005) Nonalcoholic fatty liver disease: a clinical review. Digest Dis Sci 50:171–180

    Article  PubMed  Google Scholar 

  20. Paul J, Dasgupta S, Ghosh MK, Shaw K, Roy KS, Niyogi SM (2012) A study of atherosclerosis in patients with chronic renal failure with special reference to carotid artery intima media thickness. Heart Views 13:91–96

    Article  PubMed  PubMed Central  Google Scholar 

  21. Targher G, Bertolini L, Padovani R, Zoppini G, Zenari L, Falezza G (2005) Associations between liver histology and carotid intima-media thickness in patients with nonalcoholic fatty liver disease. Arterioscler Thromb Vasc Biol 25:2687–2688

    Article  CAS  PubMed  Google Scholar 

  22. Caserta CA, Pendino GM, Amante A, Vacalebre C, Fiorillo MT, Surace P et al (2010) Cardiovascular risk factors, nonalcoholic fatty liver disease, and carotid artery intima-media thickness in an adolescent population in southern Italy. Am J Epidemiol 171:1195–1202

    Article  PubMed  Google Scholar 

  23. Volzke H, Robinson DM, Kleine V, Deutscher R, Hoffmann W, Ludemann J et al (2005) Hepatic steatosis is associated with an increased risk of carotid atherosclerosis. World J Gastroenterol 11:1848–1853

    Article  PubMed  PubMed Central  Google Scholar 

  24. Liu H, Lu HY (2014) Nonalcoholic fatty liver disease and cardiovascular disease. World J Gastroenterol 20:8407–8415

    Article  PubMed  PubMed Central  Google Scholar 

  25. Bertolotti M, Lonardo A, Mussi C, Baldelli E, Pellegrini E, Ballestri S, Romagnoli D, Loria P (2014) Nonalcoholic fatty liver disease and aging: epidemiology to management. World J Gastroenterol 20:14185–14204. doi:10.3748/wjg.v20.i39.14185

    Article  PubMed  PubMed Central  Google Scholar 

  26. Mokdad AH, Marks JS, Stroup DF, Gerberding JL (2004) Actual causes of death in the United States, 2000. JAMA 291:1238–1245

    Article  PubMed  Google Scholar 

  27. Targher G, Day CP, Bonora E (2010) Risk of cardiovascular disease in patients with nonalcoholic fatty liver disease. N Engl J Med 363:1341–1350. doi:10.1056/NEJMra0912063

    Article  CAS  PubMed  Google Scholar 

  28. Targher G, Bertolini L, Padovani R, Rodella S, Zoppini G, Zenari L et al (2006) Relations between carotid artery wall thickness and liver histology in subjects with nonalcoholic fatty liver disease. Diabetes Care 29:1325–1330

    Article  PubMed  Google Scholar 

  29. Oni ET, Agatston AS, Blaha MJ, Fialkow J, Cury R, Sposito A et al (2013) A systematic review: burden and severity of subclinical cardiovascular disease among those with nonalcoholic fatty liver; should we care? Atherosclerosis 230:258–267

    Article  CAS  PubMed  Google Scholar 

  30. Kim HC, Kim DJ, Huh KB (2009) Association between nonalcoholic fatty liver disease and carotid intima-media thickness according to the presence of metabolic syndrome. Atherosclerosis 204:521–525

    Article  CAS  PubMed  Google Scholar 

  31. Kang JH, Cho KI, Kim SM, Lee JY, Kim JJ, Goo JJ et al (2012) Relationship between nonalcoholic fatty liver disease and carotid artery atherosclerosis beyond metabolic disorders in non-diabetic patients. J Cardiovasc Ultrasound 20:126–133

    Article  PubMed  PubMed Central  Google Scholar 

  32. Stolic R, Trajkovic G, Jovanovic A, Stolić D, Perić V, Sovtić S et al (2010) Carotid ultrasonographic parameters as markers of atherogenesis and mortality rate in patients on hemodialysis. Vojnosanit Pregl 67:916–922

    Article  PubMed  Google Scholar 

  33. Hamaguchi M, Kojima T, Takeda N, Nagata C, Takeda J, Sarui H et al (2007) Nonalcolholic fatty liver disease is a novel predictor of cardiovascular disease. World J Gastroenterol 13:1579–1584

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  34. Paschos P, Paletas K (2009) Non alcoholic fatty liver disease and metabolic syndrome. Hippokratia 13:9–19

    CAS  PubMed  PubMed Central  Google Scholar 

  35. Al-Nimer MS, Hussein II (2009) Increased mean carotid intima media thickness in type 2 diabetes mellitus patients with non-blood pressure component metabolic syndrome: a preliminary report. Int J Diabetes Dev Ctries 29:19–22

    Article  PubMed  PubMed Central  Google Scholar 

  36. Mikolasevic I, Lukenda V, Racki S, Milic S, Sladoje-Martinovic B, Orlic L (2014) Nonalcoholic fatty liver disease (NAFLD)—a new factor that interplays between inflammation, malnutrition, and atherosclerosis in elderly hemodialysis patients. Clin Interv Aging 9:1295–1303. doi:10.2147/CIA.S65382

    Article  PubMed  PubMed Central  Google Scholar 

  37. Postorino M, Marino C, Tripepi G, Zoccali C (2008) Gammaglutamyltransferase in ESRD as a predictor of all-cause and cardiovascular mortality: another facet of oxidative stress burden. Kidney Int 74(Suppl 111):S64–S66

    Article  Google Scholar 

  38. Orlić L, Mikolasevic I, Bagic Z, Racki S, Stimac D, Milic S (2014) Chronic kidney disease and nonalcoholic fatty liver disease—Is there a link. Gastroenterol Res Pract. doi:10.1155/2014/847539

    PubMed  PubMed Central  Google Scholar 

  39. Dowman JK, Tomlinson JW, Newsome PN (2011) Systematic review: the diagnosis and staging of non-alcoholic fatty liver disease and non-alcoholic steatohepatitis. Aliment Pharmacol Ther 33:525–540

    Article  CAS  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Faculty of Medicine Kragujevac, Clinic of Urology and Nephrology, Clinical Center Kragujevac, University of Kragujevac, Svetozara Markovica 69, Kragujevac, 34000, Serbia

    Radojica V. Stolic

  2. Faculty of Medicine, Institute of Medical Statistics and Informatics, University of Belgrade, Belgrade, Serbia

    Goran Z. Trajkovic

  3. Faculty of Medicine Pristina/K.Mitrovica, University of Pristina, Kosovska Mitrovica, Serbia

    Mirjana M. Kostic, Sasa R. Sovtic, Andrijana M. Odalovic, Biljana D. Krdzic, Maja V. Sipic, Snezana Lazic & Zorica N. Sojevic-Timotijevic

Authors
  1. Radojica V. Stolic
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Goran Z. Trajkovic
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Mirjana M. Kostic
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Sasa R. Sovtic
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Andrijana M. Odalovic
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Biljana D. Krdzic
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Maja V. Sipic
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Snezana Lazic
    View author publications

    You can also search for this author in PubMed Google Scholar

  9. Zorica N. Sojevic-Timotijevic
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Radojica V. Stolic.

Ethics declarations

Conflict of interest

The authors declare that they have no conflict of interest.

Informed consent

Consent to submit has been received explicitly from all co-authors, as well as from the responsible authorities, before the work is submitted. Authors whose names appear on the submission have contributed sufficiently to the scientific work and therefore share collective responsibility and accountability for the results.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards. For this type of study (retrospective studies), formal consent is not required. All individuals have individual rights that are not to be infringed. This article does not contain any studies with animals performed by any of the authors.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Stolic, R.V., Trajkovic, G.Z., Kostic, M.M. et al. Correlation between nonalcoholic fatty liver and cardiovascular disease in elderly hemodialysis patients. Int Urol Nephrol 48, 883–889 (2016). https://doi.org/10.1007/s11255-016-1237-8

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11255-016-1237-8

Keywords

Search

Navigation