• Danijela Zjačić Puljiz, Ivana Kristina Delić Jukić, Marko Puljiz, Lučana Vicelić Čutura, Iva Jerčić Martinić-Ceza, Dorotea Božić, Kristian Podrug, and Željko Puljiz.
• Danijela Zjačić Puljiz, Spinčićeva 1, 21000 Split, Croatia, dzjacic@gmail.com.
• Croat. Med. J. 2021 Feb 28; 62 (1): 34-43.

AimTo evaluate liver stiffness (LS) by real-time two-dimensional shear wave elastography (RT 2D-SWE) and to assess its correlation with the mean arterial pressure (MAP) in patients on maintenance hemodialysis (MHD). The secondary aim was to identify biological and biochemical parameters associated with elevated LS.MethodsThis study enrolled patients treated with MHD in the Split University Hospital from December 2017 through February 2018. LS was measured after a HD session using RT 2D-SWE. Mean arterial pressure was measured before RT-2D-SWE was performed.ResultsThe study enrolled 47 patients with the mean±standard deviation age of 68.48±14.33 years. Arterial hypertension was diagnosed in 70.2% of patients. Liver stiffness >7 kPa, suggesting clinically relevant fibrosis, was found in 59.5% of patients. Arterial pressure was significantly correlated with LS (ρ=0.38, P=0.008). C-reactive protein (ρ=0.548, P=0.023), parathyroid hormone (ρ=0.507, P=0.038), and total bilirubin (ρ=0.423, P=0.020) were correlated with elevated LS.ConclusionMean arterial pressure is correlated with increased LS in patients on MHD. Our results emphasize the importance of proper regulation of arterial blood pressure and indicate that LS should always be interpreted in combination with laboratory parameters. Further prospective studies with larger series are needed.

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