Liu Hao-Hsuan, Yen Chieh-Li, Jeng Wen-Juei, Hung Cheng-Chieh, Hsiao Ching-Chung, Tian Ya-Chung, Chen Kuan-Hsing
Department of Nephrology, New Taipei Municipal TuCheng Hospital, New Taipei City 236043, Taiwan.
Kidney Research Center, Chang Gung Memorial Hospital, School of Medicine, Chang Gung University, Taoyuan 333423, Taiwan.
Diagnostics (Basel). 2024 Sep 15;14(18):2048. doi: 10.3390/diagnostics14182048.
Chronic hepatitis B and C infections are major causes of morbidity and mortality in end-stage kidney disease (ESKD) patients on hemodialysis (HD). The Fibrosis-4 (FIB-4) score is a non-invasive method to evaluate chronic liver disease. However, it is unclear whether there is a connection between the FIB-4 score and major adverse cardiovascular events (MACEs) and mortality in patients on HD. This study investigates the relationship between FIB-4 scores, MACEs, and mortality in HD patients.
A 5-year retrospective study included 198 HD patients with chronic hepatitis B and C from Chang Gung Memorial Hospital. FIB-4 scores were categorized into high (>2.071), middle (1.030~2.071), and low (<1.030) tertiles for cross-sectional analyses. MACEs and mortality were tracked longitudinally.
Patients with high FIB-4 scores had lower hemoglobin and albumin levels. Cox multivariate analysis showed that high FIB-4 scores (aHR: 1.589) and diabetes mellitus (aHR: 5.688) were significant factors for all-cause mortality. The optimal FIB-4 score for 5-year mortality was 2.942. FIB-4 scores were not significant for predicting 5-year MACEs.
High FIB-4 scores are associated with increased 5-year all-cause mortality risk in HD patients with chronic hepatitis virus infection.
慢性乙型和丙型肝炎感染是接受血液透析（HD）的终末期肾病（ESKD）患者发病和死亡的主要原因。Fibrosis-4（FIB-4）评分是评估慢性肝病的一种非侵入性方法。然而，FIB-4评分与HD患者的主要不良心血管事件（MACE）和死亡率之间是否存在关联尚不清楚。本研究调查了HD患者中FIB-4评分、MACE和死亡率之间的关系。
一项为期5年的回顾性研究纳入了长庚纪念医院198例患有慢性乙型和丙型肝炎的HD患者。FIB-4评分被分为高（>2.071）、中（1.030~2.071）和低（<1.030）三分位数进行横断面分析。纵向跟踪MACE和死亡率。
FIB-4评分高的患者血红蛋白和白蛋白水平较低。Cox多变量分析显示，高FIB-4评分（aHR：1.589）和糖尿病（aHR：5.688）是全因死亡率的重要因素。5年死亡率的最佳FIB-4评分为2.942。FIB-4评分对预测5年MACE无显著意义。
高FIB-4评分与慢性肝炎病毒感染的HD患者5年全因死亡风险增加相关。
