P0923 - Prevalence of Hepatic Steatosis and Fibrosis in Patients Listed for Renal Transplant

Kareem Marrache, MD¹, Pradeep Yarra, MD, MSc², Patrick Brotherton, MD¹, Metta Nguyen, MD¹, Jay Shah, DO¹, Tim Brotherton, MD¹, Kamran Qureshi, MD^1
1Saint Louis University, St. Louis, MO; ²Saint Louis University Hospital, St. Louis, MO

Introduction: It is estimated that 25-30% of general population has NAFLD and its prevalence is rising in parallel with increases in the prevalence of obesity and metabolic comorbid disease (insulin resistance, dyslipidemia, central obesity, and hypertension). Similar risk factors are noted in patients with CKD, ESRD among those who are on dialysis. NAFLD could complicate post-renal transplant (RT) care. So far there has been scarce evidence of the prevalence of NAFLD among ESRD patients awaiting RT. We investigated the prevalence of moderate–severe hepatic steatosis and fibrosis using Fibroscan in a cohort of patients listed for RT.

Methods: This is a single center retrospective study of all patients with ESRD who were active on RT waitlist at our center and had undergone Fibroscan to screen for presence of liver disease. Medical records were abstracted to capture demographic data, Fibroscan results, past medical history (including comorbidities constituting metabolic syndrome). Significant alcohol use was not allowed for patients listed for RT. Cut-off used were documented in table. The study was approved by the institutional review board (IRB). Statistical analysis was performed using SPSS.


Results: We identified 57 ESRD waitlist patients who had fibroscans performed during the RT work up (Table). The average age was 59 yrs. 31 (54%) patients were White and 21 (37%) were Black. Presence of steatosis was noted in 74% while moderate to high probability of fibrosis was noted in 26%. A significant positive correlation was noted between BMI and liver stiffness measurements (p=0.02) and CAP scores (0.03). In addition, HDL levels were significantly lower in patients with higher levels of steatosis compared to lower (0.05) (Table). 9 (60%) and 24 (57%) patients were found to have diabetes and high probability of fibrosis or any steatosis, respectively.

Discussion: Based on Fibroscan evaluation patients awaiting RT have a high prevalence of hepatic steatosis, and fibrosis when compared with general population (26% vs 8% and 74% vs 27% respectively)1, further studies are needed to fully delineate the relationship between chronic kidney disease and liver disease. Also , follow up studies are needed to evaluate impact of NAFLD on post RT outcomes.

1. Choi YS, Beltran TA, Calder SA, Padilla CR, Berry-Cabán CS, Salyer KR. Prevalence of Hepatic Steatosis and Fibrosis in the United States. Metab Syndr Relat Disord. 2022;20(3):141-147. doi:10.1089/met.2021.0111




Disclosures:


Kareem Marrache, MD¹, Pradeep Yarra, MD, MSc², Patrick Brotherton, MD¹, Metta Nguyen, MD¹, Jay Shah, DO¹, Tim Brotherton, MD¹, Kamran Qureshi, MD¹. P0923 - Prevalence of Hepatic Steatosis and Fibrosis in Patients Listed for Renal Transplant, ACG 2023 Annual Scientific Meeting Abstracts. Vancouver, BC, Canada: American College of Gastroenterology.