S2562 Correlation of Fibroscan-Derived and Laboratory-Based Non-Invasive Tests to Assess Liver Fibrosis in Dialysis Patients Awaiting Kidney Transplantation

Introduction: Assessment of liver fibrosis in dialysis-dependent patients is essential for kidney transplant (KT) evaluation, as cirrhosis or portal hypertension may necessitate combined liver-kidney transplantation or care with using hepatitis C positive donors. Liver biopsy, though definitive, poses procedural risks in this population. Fibroscan or Vibration-controlled transient elastography (VCTE) offers a non-invasive alternative but may not be universally available. Blood-based non-invasive tests (NITs) such as APRI, FIB-4, and Fibroscan-derived scores are suggested, but their diagnostic utility in this specific population remains unclear. This study investigates the correlation between VCTE-derived liver stiffness measurement (LSM) and various NITs in dialysis patients awaiting KT. Methods: This single-center retrospective study included patients on the KT waitlist who underwent VCTE. Charts were reviewed for VCTE data and laboratory values required to calculate NITs, including APRI, FIB-4, NAFLD Fibrosis Score (NFS), FAST, AGILE3, and AGILE4. Lab values were collected closest to the VCTE date. LSM and NITs were assessed for normality and homoscedasticity. Spearman’s rank correlation was used to evaluate the association between NITs and LSM. Results: A total of 57 patients were included in this study; 61% were man, with a median age of 61 years. The mean LSM by VCTE was 6.2 ± 2.7 kPa. No significant correlation was observed between LSM and APRI (rₛ = 0.116, P = 0.195), FIB-4 (rₛ = 0.126, P = 0.175), or NFS (rₛ = 0.056, P = 0.339). In contrast, significant positive correlations were found between LSM and Fibroscan-based scores: AGILE3 (rₛ = 0.630, P < 0.001), AGILE4 (rₛ = 0.723, P < 0.001), and FAST (rₛ = 0.412, P < 0.001). Conclusion: In this cohort of dialysis-dependent patients awaiting KT, the suggested laboratory-based NITs—APRI, FIB-4, and NFS—did not significantly correlate with VCTE-derived LSM, limiting their dependability for fibrosis assessment in this population. Fibroscan-based scores (AGILE3, AGILE4, and FAST) demonstrated moderate to strong correlations. Further studies are needed to validate and define the diagnostic accuracy of these NITs for staging liver disease.