Metabolically associated fatty liver disease in patients with chronic kidney disease receiving program hemodialysis (pilot study results)

Background: chronic kidney disease (CKD) and metabolically associated fatty liver disease (MAFLD) have interrelated progression mechanisms and lead to an increased risk of cardiovascular diseases. MAFLD adversely affects clinical outcomes and all-cause mortality in patients with CKD, and it increases a need for program hemodialysis (PHD). Aim: to study prevalence and severity of MAFLD in PHD patients with cardiometabolic conditions (CMCs) by non-invasive methods. Materials and Methods: 20 PHD (dialysis time — 9,25±7,8 [1; 27] years) patients with CKD associated with CMCs (hypertension, type 2 diabetes mellitus, dyslipidemia, visceral obesity) were enrolled in the pilot study. A general clinical test, general and biochemical blood tests were performed. Liver status was assessed by non-invasive diagnostic methods (AUDIT test, Charlson, St-index, APRI, FIB-4, and NAFLD indices). Results: chronic glomerulonephritis was the most common cause of CKD in the examined patients. According to the St-index values, a low risk of steatosis was reported in 85% of cases (means — 2.361±1.041); initial stage of fibrosis (F0–F2) was diagnosed in 95%, 85% and 50% of patients as per the APRI, FIB, and NAFLD indices, respectively. Charlson index values were high in 75% of patients. 3 CMCs were associated with steatosis and liver fibrosis. Conclusion: according to results of the study in PHD patients with CKD associated with CMCs, a low risk of steatosis was reported in most cases. The APRI and FIB-4 fibrosis indices demonstrated its initial stage (F0–F2) in most patients, while NAFLD proved to be uninformative. The combination of 3 CMCs, regardless of a non-invasive diagnostic method, was associated with steatosis and liver fibrosis. Keywords: chronic kidney disease, program hemodialysis, metabolically associated fatty liver disease, Charlson index, St-index, APRI, FIB-4, NAFLD. For citation: Kupriyanova I.N., Martsinkovskyi D.A., Postnikova E.A., Abrosimov A.V., Mironova E.V. Metabolically associated fatty liver disease in patients with chronic kidney disease receiving program hemodialysis (pilot study results). RMJ. 2025;2:8–12. DOI: 10.32364/2225- 2282-2025-2-2