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

• Published in: Wiener Klinische Wochenschrift Vol. 133; no. 3-4; pp. 96 - 101
• Main Authors: Zjacic Puljiz, Danijela, Mestrovic, Antonio, Zaja, Ivan, Tonkic, Ante, Grgurevic, Ivica, Duplancic, Darko, Delic Jukic, Ivana Kristina, Ljutic, Dragan, Puljiz, Zeljko
• Format: Journal Article
• Language: English
• Published: Vienna Springer Vienna 01-02-2021
• Subjects: Aged; Aged, 80 and over; Elasticity Imaging Techniques; Endocrinology; Gastroenterology; Humans; Internal Medicine; Kidney Failure, Chronic - diagnostic imaging; Kidney Failure, Chronic - therapy; Liver - diagnostic imaging; Liver - pathology; Liver Cirrhosis; Medicine; Medicine & Public Health; Middle Aged; Original Article; Pneumology/Respiratory System; Renal Dialysis; Dialysis; Chronic kidney disease; Liver fibrosis; End stage renal disease; Net fluid withdrawal
• ISSN: 0043-5325; 1613-7671
• DOI: 10.1007/s00508-019-01577-w

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.