title: Relationship between non-alcoholic fatty liver disease and MIA syndrome.
abstract: Non-alcoholic fatty liver disease (NAFLD) is an important factor in the pathogenesis of cardiovascular diseases in the general population. Recently, it has been shown that NAFLD is highly prevalent in chronic kidney disease (CKD) patients. Ninety-four hemodialysis (HD) patients were followed for a time period of 18 months or until death. Patient's survival rate was determined in relation to their nutritional and inflammatory state, and the presence of NAFLD. We also investigated the association between the presence of NAFLD and the patients' nutritional and inflammatory state. We did not find any significant association between the clinical parameters of nutritional status and the mortality rate. However, the mortality rate was statistically significantly higher in patients with low serum albumin and high high-sensitive C-reactive protein (hs-CRP) levels and in those who had NAFLD. Surprisingly, patients who had received enteral nutrition did not have a better survival rate. The severity of liver steatosis was negatively correlated with the serum albumin levels, while it was positively correlated with hs-CRP values. Furthermore, serum albumin levels showed a negative correlation with hs-CRP levels. We did not find any significant association between the presence of NAFLD and clinical parameters of nutrition. We have shown that NAFLD could be one more possible example of reverse epidemiology in patients undergoing HD. NAFLD may be the missing link that causally ties malnutrition, inflammation, and atherosclerosis syndrome to the morbidity and mortality in patients undergoing HD.
authors: Department of Nephrology, Dialysis and Kidney Transplantation, University Hospital Center Rijeka, Rijeka, Croatia.
authors: Ivana
authors: I
authors: Mikolasevic
authors: Department of Gastroenterology, University Hospital Center Rijeka, Rijeka, Croatia.
authors: Davor
authors: D
authors: Stimac
authors: Department of Nephrology, Dialysis and Kidney Transplantation, University Hospital Center Rijeka, Rijeka, Croatia.
authors: Sanjin
authors: S
authors: Racki
authors: Department of Cardiology, University Hospital Center Rijeka, Rijeka, Croatia.
authors: Luka
authors: L
authors: Zaputovic
authors: Department of Nephrology, Dialysis and Kidney Transplantation, University Hospital Center Rijeka, Rijeka, Croatia.
authors: Bosiljka
authors: B
authors: Devcic
authors: Department of Nephrology, Dialysis and Kidney Transplantation, University Hospital Center Rijeka, Rijeka, Croatia.
authors: Ita
authors: I
authors: Jelic
authors: Department of Internal Medicine, General Hospital "Dr. Josip Bencevic", Slavonski Brod, Croatia.
authors: Vesna
authors: V
authors: Lukenda
authors: Department of Gastroenterology, University Hospital Center Rijeka, Rijeka, Croatia.
authors: Mladen
authors: M
authors: Radic
authors: Department of Nephrology, Dialysis and Kidney Transplantation, University Hospital Center Rijeka, Rijeka, Croatia.
authors: Lidija
authors: L
authors: Orlic
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D050197:Atherosclerosis / Q000097:blood* / Q000209:etiology / Q000503:physiopathology; D002097:C-Reactive Protein / Q000032:analysis* / Q000378:metabolism; D005260:Female; D006801:Humans; D007249:Inflammation / Q000097:blood*; D008297:Male; D044342:Malnutrition / Q000097:blood* / Q000209:etiology / Q000503:physiopathology; D008875:Middle Aged; D065626:Non-alcoholic Fatty Liver Disease / Q000150:complications* / Q000401:mortality; D009752:Nutritional Status; D015995:Prevalence; D011446:Prospective Studies; D006435:Renal Dialysis / Q000379:methods*; D051436:Renal Insufficiency, Chronic / Q000150:complications* / Q000401:mortality; D015996:Survival Rate
chemical_list: D002097:C-Reactive Protein
keywords: Hemodialysis; malnutrition; mortality; non-alcoholic fatty liver disease