title: Association of fatty liver disease with nonfatal cardiovascular events in patients undergoing maintenance hemodialysis.
abstract: OBJECTIVE
  The prevalence of cardiovascular (CV) disease in patients undergoing maintenance hemodialysis (HD) is reportedly higher than that in healthy individuals. In the present study, we aimed to investigate whether ultrasonographically documented fatty liver disease (FLD) is an independent risk factor for nonfatal CV events in patients undergoing HD.
  
  
  METHODS
  A retrospective cohort study was conducted in a medical center in southern Taiwan. The medical records of 490 patients undergoing HD who were enrolled between July 1998 and October 2012 were screened. Finally, 278 patients who had undergone hepatic ultrasonography and had available data were recruited in the present study. The patients included 130 men and 148 women; their mean age was 59.9 years. The primary endpoint was nonfatal CV events in the observation period. The comparable data included epidemiological, hematological, and biochemical profiles. A time-dependent statistical method was used to analyze the associated factors.
  
  
  RESULTS
  The prevalence of nonfatal CV events was significantly increased in the patients with FLD compared with those without FLD (CV events: 32 vs. 18%, respectively; p = 0.008). After adjusting for associated risk factors (sex, age, body mass index, smoking, diabetes, hypertension, dyslipidemia, and Kt/V), multivariate analyses identified FLD (CV events: hazard ratio 2.84, 95% confidence interval 1.52-5.28, p = 0.001), advanced age, and diabetes to be independently associated with nonfatal CV events.
  
  
  CONCLUSIONS
  The study suggests that FLD was an independent risk factor for nonfatal CV events in patients undergoing maintenance HD.
authors: Division of Nephrology, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Kaohsiung, Taiwan, ROC.
authors: Yu-Cheng
authors: YC
authors: Lai
authors: Ben-Chung
authors: BC
authors: Cheng
authors: Jyh-Chang
authors: JC
authors: Hwang
authors: Yueh-Ting
authors: YT
authors: Lee
authors: Chien-Hua
authors: CH
authors: Chiu
authors: Li-Chueh
authors: LC
authors: Kuo
authors: Jin-Bor
authors: JB
authors: Chen
mesh_terms: D000368:Aged; D002318:Cardiovascular Diseases / Q000000981:diagnostic imaging* / Q000453:epidemiology / Q000628:therapy; D015331:Cohort Studies; D005234:Fatty Liver / Q000000981:diagnostic imaging* / Q000453:epidemiology / Q000628:therapy; D005260:Female; D006801:Humans; D007676:Kidney Failure, Chronic / Q000000981:diagnostic imaging* / Q000453:epidemiology / Q000628:therapy; D008297:Male; D008875:Middle Aged; D065626:Non-alcoholic Fatty Liver Disease; D006435:Renal Dialysis / Q000009:adverse effects; D012189:Retrospective Studies; D012307:Risk Factors; D014463:Ultrasonography