caa a22 4500 606241310 CHVBK 20210128101312.0 cr unu---uuuuu 210128e20150501xx s 000 0 eng 10.1007/s00508-014-0661-y doi (NATIONALLICENCE)springer-10.1007/s00508-014-0661-y Nonalcoholic fatty liver disease and the renin-angiotensin system blockers in the patients with chronic kidney disease [Elektronische Daten] [Lidija Orlic, Ivana Mikolasevic, Vesna Lukenda, Kata Anic, Ita Jelic, Sanjin Racki] Nicht-alkoholische Fettleber und Blocker des Renin-Angiotensin Systems bei Patienten mit chronischer Nierenerkrankung Summary: Background: Recent data suggest that the renin-angiotensin-aldosteron system (RAAS) may be of importance in the pathogenesis of nonalcoholic fatty liver disease (NAFLD). We were interested to investigate whether the therapy with RAAS blockers in patients with different stages of chronic kidney disease (CKD) has any effect on steatosis and fibrosis grade; NAFLD documented by transient elastography (TE) (Fibroscan®-CAP). Methods: Of 191 patients with various stages of CKD there were 61 patients with CKD grade III and IV, 62 patients with end-stage renal disease treated with chronic hemodialysis and 68 renal transplant recipients. Liver stiffness was selected as the parameter to quantify liver fibrosis. Furthermore, the Controlled Attenuation Parameter (CAP) was used to detect and quantify liver steatosis with the help of TE. Results: CKD patients (p=0.005) and CKD-NAFLD patients (p=0.0005) with angiotensin-converting enzyme inhibitors (ACE-I) or angiotensin receptor blockers (ARBs) had statistically significant lower degree of liver stiffness in comparison to those without these medications (p=0.005). Also, we were interested to explore is there any difference in fibrosis and steatosis grade due to use of ACE-I or ARBs. We did not find statistically significant differences between those two subgroups of patients with respect to liver steatosis/fibrosis. Conclusion: Based on our results, RAAS blockers could be an attractive option for the management of NAFLD. We believe that TE provides the opportunity of noninvasive screening of NAFLD in CKD patients. In further prospective analysis, we believe that by using TE as noninvasive method we could investigate are ACE-I/ARBs really effective medications for the treatment of NAFLD in CKD patients. Springer-Verlag Wien, 2014 Renin-angiotensin-aldosteron system nationallicence Nonalcoholic fatty liver disease (NAFLD) nationallicence Chronic kidney disease nationallicence Transient elastography nationallicence Non-invasive screening nationallicence Renin-Angiotensin-Aldosteron System nationallicence Nicht-alkoholische Fettleber nationallicence Chronische Nierenerkankung nationallicence Transiente Elastographie nationallicence Nicht-invasives Screening nationallicence Orlic Lidija Department of Nephrology, Dialysis and Kidney Transplantation, University Hospital Center Rijeka, Tome Strižića 3, 51000, Rijeka, Croatia aut Mikolasevic Ivana Department of Nephrology, Dialysis and Kidney Transplantation, University Hospital Center Rijeka, Tome Strižića 3, 51000, Rijeka, Croatia aut Lukenda Vesna Department of Internal Medicine, General Hospital "Dr. Josip Bencevic”, Slavonski Brod, Croatia aut Anic Kata Infectious Disease Clinic, UHC Osijek, Osijek, Croatia aut Jelic Ita Department of Nephrology, Dialysis and Kidney Transplantation, University Hospital Center Rijeka, Tome Strižića 3, 51000, Rijeka, Croatia aut Racki Sanjin Department of Nephrology, Dialysis and Kidney Transplantation, University Hospital Center Rijeka, Tome Strižića 3, 51000, Rijeka, Croatia aut Wiener klinische Wochenschrift Springer Vienna 127/9-10(2015-05-01), 355-362 0043-5325 127:9-10<355 2015 127 508 https://doi.org/10.1007/s00508-014-0661-y text/html Onlinezugriff via DOI BK010053 XK010053 XK010000 Metadata rights reserved Springer special CC-BY-NC licence nationallicence 1 research-article jats NATIONALLICENCE NATIONALLICENCE NL-springer NATIONALLICENCE 856 40 https://doi.org/10.1007/s00508-014-0661-y text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Orlic Lidija Department of Nephrology, Dialysis and Kidney Transplantation, University Hospital Center Rijeka, Tome Strižića 3, 51000, Rijeka, Croatia aut NATIONALLICENCE 700 1- Mikolasevic Ivana Department of Nephrology, Dialysis and Kidney Transplantation, University Hospital Center Rijeka, Tome Strižića 3, 51000, Rijeka, Croatia aut NATIONALLICENCE 700 1- Lukenda Vesna Department of Internal Medicine, General Hospital "Dr. Josip Bencevic”, Slavonski Brod, Croatia aut NATIONALLICENCE 700 1- Anic Kata Infectious Disease Clinic, UHC Osijek, Osijek, Croatia aut NATIONALLICENCE 700 1- Jelic Ita Department of Nephrology, Dialysis and Kidney Transplantation, University Hospital Center Rijeka, Tome Strižića 3, 51000, Rijeka, Croatia aut NATIONALLICENCE 700 1- Racki Sanjin Department of Nephrology, Dialysis and Kidney Transplantation, University Hospital Center Rijeka, Tome Strižića 3, 51000, Rijeka, Croatia aut NATIONALLICENCE 773 0- Wiener klinische Wochenschrift Springer Vienna 127/9-10(2015-05-01), 355-362 0043-5325 127:9-10<355 2015 127 508