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Serum hyaluronic acid in chronic viral hepatitis B and C: a biomarker for assessing liver fibrosis in chronic hemodialysis patients

  • Nephrology - Original Paper
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Abstract

Purpose

Serum hyaluronic acid (sHA) is studied as a noninvasive marker of liver fibrosis (F) in chronic B and C viral hepatitis in general population but less in end-stage renal disease patients undergoing hemodialysis.

Methods

We evaluated sHA as a noninvasive biomarker of F in a multicenter prospective, transversal, and observational study which included 52 end-stage renal disease patients with chronic B (14) and C (38) viral hepatitis (age 55.57 ± 14.46 years, dialysis vintage 132.59 ± 86.02 months).

Results

Of the noninvasive tests analyzed, only sHA, APRI, and FIB4 index were able to differentiate patients with F1 (sHA p = 0.006; APRI p = 0.031; FIB4 p = 0.016). No statistically significant differences were found between sHA and APRI, ASAT/ALAT ratio, and FIB4 index in detecting F1 a (p > 0.02). sHA seemed to be more efficient than APRI, ASAT/ALAT ratio, and FIB4 index, having the highest estimated AUC value. The sHA threshold value for F1 was equal to 33.46 ng/mL, with the following estimated values of the performance indicators: Se 88.46 % and Sp 50 %. sHA was the only noninvasive test of the studied tests that could determine F2 (p = 0.002), with a threshold value of 80.24 ng/mL (Se 63 %, Sp 88 %), and F3 (p = 0.008), with a threshold value of 88.54 ng/mL (Se 60 %, Sp 84 %). None of the studied noninvasive tests could determine F4.

Conclusions

In patients with chronic B and C viral hepatitis undergoing hemodialysis, sHA may be a useful biomarker for the liver fibrosis grades: F1—mild, F2—moderate, and F3—severe, but it does not differentiate between chronic hepatitis (F1–F3) and liver cirrhosis (F4).

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Conflict of interest

This paper was published under the frame of the European Social Fund, Human Resources Development Operational Programme 2007–2013, project no. POSDRU/159/1.5/S/138776.

Ethical standards

All procedures performed in the study involving human participants were in accordance with the ethical standards of the institutional and national research committees and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

Informed consent

Informed consent was obtained from all individual participants in the study.

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Author notes

    Authors and Affiliations

    1. 4th Medical Department, University of Medicine and Pharmacy, Cluj-Napoca, Romania

      Olga Hilda Orăşan, Angela Cozma & Simina Sarlea Ţărmure

    2. University of Medicine and Pharmacy, Cluj-Napoca, Romania

      Mădălina Sava

    3. Medical Informatics and Biostatistics, University of Medicine and Pharmacy, Cluj-Napoca, Romania

      Mihaela Iancu

    4. Heart Institute, University of Medicine and Pharmacy, Cluj-Napoca, Romania

      Aniela Saplonţai-Pop

    5. 4th Surgical Department, University of Medicine and Pharmacy, Cluj-Napoca, Romania

      Corneliu Lungoci

    6. Nefromed Dialysis Centers, Cluj-Napoca, Romania

      Remus Aurel Orăşan & Ioan Mihai Patiu

    7. 2nd Medical Department, University of Medicine and Pharmacy, Cluj-Napoca, Romania

      Dan Lucian Dumitraşcu

    Authors
    1. Olga Hilda Orăşan
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    2. Mădălina Sava
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    Correspondence to Olga Hilda Orăşan.

    Additional information

    Olga Hilda Orăşan and Mihaela Iancu have equally contributed to this work.

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    Orăşan, O.H., Sava, M., Iancu, M. et al. Serum hyaluronic acid in chronic viral hepatitis B and C: a biomarker for assessing liver fibrosis in chronic hemodialysis patients. Int Urol Nephrol 47, 1209–1217 (2015). https://doi.org/10.1007/s11255-015-1017-x

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    • DOI: https://doi.org/10.1007/s11255-015-1017-x

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