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Impact of hemodialysis on liver stiffness measured with real-time two-dimensional shear wave elastography

Wiener klinische Wochenschrift volume 133, pages 96–101 (2021)Cite this article

Summary

Background and aims

The impact of hemodialysis on liver stiffness is still unclear. The aim of the study was to assess liver fibrosis by real-time two-dimensional shear wave elastography (RT 2D-SWE) and to quantify the influence of net fluid withdrawal on liver stiffness during one hemodialysis session. The second aim was to investigate the influence of systolic blood pressure and time spent on dialysis (in years) on liver stiffness measurements.

Methods

This before/after hemodialysis (HD) study in a group of end stage renal disease (ESRD) patients was carried out with patients on regular HD. Measurements of liver stiffness were done using RT 2D-SWE directly before and after a hemodialysis session.

Results

In this study 27 patients with mean age 69.4 ± 14.75 years were included. Mean net fluid withdrawal volume per session was 2874.07 ± 778.35 ml. Mean pre-HD and post-HD liver stiffness measurements were 8.15 kPa (95% confidence interval, CI 7.61–8.68) and 6.70 kPa (95% CI 6.10–7.30 kPa), respectively. Mean liver stiffness reduction was 1.448 ± 1.14 kPa. The amount of fluid removed correlated with the decline in liver stiffness values after HD (ρ = 0.523, P = 0.003). There was a positive but statistically not significant correlation between time spent in HD and liver stiffness (ρ = 0.151, P = 0.623)

Conclusion

Liver stiffness significantly declined after one session of HD. The change in liver stiffness was strongly correlated with the amount of net fluid withdrawal. Random liver stiffness measurements (LSM) by RT 2D-SWE does not precisely show the degree of fibrosis, Furthermore, it is presumed that postdialysis liver stiffness values likely reflect the real degree of liver fibrosis.

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Funding

Departmental sources.

Author information

Affiliations

  1. Department of Nephrology and Dialysis, University Hospital Split, Split, Croatia

    Danijela Zjacic Puljiz, Ivana Kristina Delic Jukic & Dragan Ljutic

  2. Department of Gastroenterology, University Hospital Split, 21 000, Split, Croatia

    Antonio Mestrovic, Ivan Zaja, Ante Tonkic MD, PhD & Zeljko Puljiz

  3. Department of Gastroenterology, University Hospital Dubrava, Zagreb, Croatia

    Ivica Grgurevic

  4. Department of Cardiology, University Hospital Split, Split, Croatia

    Darko Duplancic

Authors
  1. Danijela Zjacic Puljiz
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  2. Antonio Mestrovic
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  3. Ivan Zaja
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  4. Ante Tonkic MD, PhD
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  5. Ivica Grgurevic
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  6. Darko Duplancic
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  7. Ivana Kristina Delic Jukic
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  8. Dragan Ljutic
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  9. Zeljko Puljiz
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Corresponding author

Correspondence to Ante Tonkic MD, PhD.

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Conflict of interest

D. Zjacic Puljiz, A. Mestrovic,I. Zaja, A. Tonkic, I. Grgurevic, D. Duplancic, I.K. Delic Jukic, D. Ljutic and Z. Puljiz declare that they have no competing interests. The results presented in this paper have not been published previously in whole or part, except in abstract format.

Ethical standards

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 1975 Helsinki declaration and its later amendments or comparable ethical standards. The study protocol was approved by the ethics committee of the University Hospital Centre Split. Prior to recruitment, informed consent was obtained from all participants.

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Zjacic Puljiz, D., Mestrovic, A., Zaja, I. et al. Impact of hemodialysis on liver stiffness measured with real-time two-dimensional shear wave elastography. Wien Klin Wochenschr 133, 96–101 (2021). https://doi.org/10.1007/s00508-019-01577-w

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  • DOI: https://doi.org/10.1007/s00508-019-01577-w

Keywords

  • Dialysis
  • Liver fibrosis
  • Net fluid withdrawal
  • Chronic kidney disease
  • End stage renal disease