title: Transient Elastography in End-Stage Renal Disease Patients on Hemodialysis: The Effect of Net Fluid Withdrawal.
abstract: OBJECTIVE
  The impact of volume status on liver stiffness measurement (LSM) as measured by transient elastography (TE) as in end-stage renal disease (ESRD) was unclear. We evaluated LSM before and after hemodialysis (HD) and identified the associated factors if the difference of LSM existed.
  
  
  METHODS
  A cross-sectional study was conducted in ESRD patients on regular HD. Subjects underwent TE and bioelectrical impedance before and after HD.
  
  
  RESULTS
  Thirty-six patients were enrolled. Mean (SD) net fluid withdrawal volume (NFWV) per session was 2.55 (0.9) l. Median (range) pre- and post-HD LSMs were 5.38 (2.8-25.7) and 5.4 (2.8-26) kPa, respectively (p = 0.712). Mean differences of pre- and post-HD LSMs correlated with NFWV (r = 0.49, 95% CI 0.19-0.71, p = 0.002).
  
  
  CONCLUSIONS
  In ESRD on regular HD, LSM is not affected by HD. TE can be done before or after HD with similar results. However, fluid excess at pre-HD can cause inaccurately high LSM.
authors.affiliation: Division of Gastroenterology and Hepatology, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand.
authors.forename: Narongrit
authors.initials: N
authors.lastname: Khunpakdee
authors.forename: Kullapong
authors.initials: K
authors.lastname: Jayanama
authors.forename: Piyaporn
authors.initials: P
authors.lastname: Kaewdoung
authors.forename: Kwannapa
authors.initials: K
authors.lastname: Promson
authors.forename: Sasivimol
authors.initials: S
authors.lastname: Rattanasiri
authors.forename: Daruneewan
authors.initials: D
authors.lastname: Warodomwichit
authors.forename: Surasak
authors.initials: S
authors.lastname: Kantachuvesiri
authors.forename: Abhasnee
authors.initials: A
authors.lastname: Sobhonslidsuk
mesh_terms: D000368:Aged; D001826:Body Fluids / Q000378:metabolism; D003430:Cross-Sectional Studies; D004548:Elasticity; D054459:Elasticity Imaging Techniques / Q000592:standards*; D017097:Electric Impedance; D005260:Female; D006801:Humans; D007668:Kidney / Q000378:metabolism / Q000473:pathology; D007676:Kidney Failure, Chronic / Q000150:complications / Q000378:metabolism / Q000473:pathology / Q000628:therapy*; D008099:Liver / Q000378:metabolism / Q000473:pathology*; D008103:Liver Cirrhosis / Q000150:complications / Q000175:diagnosis* / Q000378:metabolism / Q000473:pathology; D008297:Male; D008875:Middle Aged; D006435:Renal Dialysis