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Splenic Arterial Pulsatility Index to Predict Hepatic Fibrosis in Hemodialysis Patients with Chronic Hepatitis C Virus Infection

The clinical utility of the splenic arterial pulsatility index (SAPI), a duplex Doppler ultrasonographic index, to predict the stage of hepatic fibrosis in hemodialysis patients with chronic hepatitis C virus (HCV) infection remains elusive. We conducted a retrospective, cross-sectional study to inc...

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Autores principales: Liu, Chen-Hua, Fang, Yu-Jen, Liu, Chun-Jen, Su, Tung-Hung, Huang, Shang-Chin, Tseng, Tai-Chung, Wu, Jo-Hsuan, Chen, Pei-Jer, Kao, Jia-Horng
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10004191/
https://www.ncbi.nlm.nih.gov/pubmed/36902807
http://dx.doi.org/10.3390/jcm12052020
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author Liu, Chen-Hua
Fang, Yu-Jen
Liu, Chun-Jen
Su, Tung-Hung
Huang, Shang-Chin
Tseng, Tai-Chung
Wu, Jo-Hsuan
Chen, Pei-Jer
Kao, Jia-Horng
author_facet Liu, Chen-Hua
Fang, Yu-Jen
Liu, Chun-Jen
Su, Tung-Hung
Huang, Shang-Chin
Tseng, Tai-Chung
Wu, Jo-Hsuan
Chen, Pei-Jer
Kao, Jia-Horng
author_sort Liu, Chen-Hua
collection PubMed
description The clinical utility of the splenic arterial pulsatility index (SAPI), a duplex Doppler ultrasonographic index, to predict the stage of hepatic fibrosis in hemodialysis patients with chronic hepatitis C virus (HCV) infection remains elusive. We conducted a retrospective, cross-sectional study to include 296 hemodialysis patients with HCV who underwent SAPI assessment and liver stiffness measurements (LSMs). The levels of SAPI were significantly associated with LSMs (Pearson correlation coefficient: 0.413, p < 0.001) and different stages of hepatic fibrosis as determined using LSMs (Spearman’s rank correlation coefficient: 0.529, p < 0.001). The areas under receiver operating characteristics (AUROCs) of SAPI to predict the severity of hepatic fibrosis were 0.730 (95% CI: 0.671–0.789) for ≥F1, 0.782 (95% CI: 0.730–0.834) for ≥F2, 0.838 (95% CI: 0.781–0.894) for ≥F3, and 0.851 (95% CI: 0.771–0.931) for F4. Furthermore, the AUROCs of SAPI were comparable to those of the fibrosis index based on four parameters (FIB-4) and superior to those of the aspartate transaminase (AST)-to-platelet ratio index (APRI). The positive predictive value (PPV) for ≥F1 was 79.5% when the Youden index was set at 1.04, and the negative predictive values (NPVs) for ≥F2, ≥F3, and F4 were 79.8%, 92,6%, and 96.9%, respectively, when the maximal Youden indices were set at 1.06, 1.19, and 1.30. The diagnostic accuracies of SAPI with the maximal Youden index for a fibrosis stage of ≥F1, ≥F2, ≥F3, and F4 were 69.6%, 67.2%, 75.0%, and 85.1%, respectively. In conclusion, SAPI can serve as a good noninvasive index in predicting the severity of hepatic fibrosis in hemodialysis patients with chronic HCV infection.
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spelling pubmed-100041912023-03-11 Splenic Arterial Pulsatility Index to Predict Hepatic Fibrosis in Hemodialysis Patients with Chronic Hepatitis C Virus Infection Liu, Chen-Hua Fang, Yu-Jen Liu, Chun-Jen Su, Tung-Hung Huang, Shang-Chin Tseng, Tai-Chung Wu, Jo-Hsuan Chen, Pei-Jer Kao, Jia-Horng J Clin Med Article The clinical utility of the splenic arterial pulsatility index (SAPI), a duplex Doppler ultrasonographic index, to predict the stage of hepatic fibrosis in hemodialysis patients with chronic hepatitis C virus (HCV) infection remains elusive. We conducted a retrospective, cross-sectional study to include 296 hemodialysis patients with HCV who underwent SAPI assessment and liver stiffness measurements (LSMs). The levels of SAPI were significantly associated with LSMs (Pearson correlation coefficient: 0.413, p < 0.001) and different stages of hepatic fibrosis as determined using LSMs (Spearman’s rank correlation coefficient: 0.529, p < 0.001). The areas under receiver operating characteristics (AUROCs) of SAPI to predict the severity of hepatic fibrosis were 0.730 (95% CI: 0.671–0.789) for ≥F1, 0.782 (95% CI: 0.730–0.834) for ≥F2, 0.838 (95% CI: 0.781–0.894) for ≥F3, and 0.851 (95% CI: 0.771–0.931) for F4. Furthermore, the AUROCs of SAPI were comparable to those of the fibrosis index based on four parameters (FIB-4) and superior to those of the aspartate transaminase (AST)-to-platelet ratio index (APRI). The positive predictive value (PPV) for ≥F1 was 79.5% when the Youden index was set at 1.04, and the negative predictive values (NPVs) for ≥F2, ≥F3, and F4 were 79.8%, 92,6%, and 96.9%, respectively, when the maximal Youden indices were set at 1.06, 1.19, and 1.30. The diagnostic accuracies of SAPI with the maximal Youden index for a fibrosis stage of ≥F1, ≥F2, ≥F3, and F4 were 69.6%, 67.2%, 75.0%, and 85.1%, respectively. In conclusion, SAPI can serve as a good noninvasive index in predicting the severity of hepatic fibrosis in hemodialysis patients with chronic HCV infection. MDPI 2023-03-03 /pmc/articles/PMC10004191/ /pubmed/36902807 http://dx.doi.org/10.3390/jcm12052020 Text en © 2023 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Liu, Chen-Hua
Fang, Yu-Jen
Liu, Chun-Jen
Su, Tung-Hung
Huang, Shang-Chin
Tseng, Tai-Chung
Wu, Jo-Hsuan
Chen, Pei-Jer
Kao, Jia-Horng
Splenic Arterial Pulsatility Index to Predict Hepatic Fibrosis in Hemodialysis Patients with Chronic Hepatitis C Virus Infection
title Splenic Arterial Pulsatility Index to Predict Hepatic Fibrosis in Hemodialysis Patients with Chronic Hepatitis C Virus Infection
title_full Splenic Arterial Pulsatility Index to Predict Hepatic Fibrosis in Hemodialysis Patients with Chronic Hepatitis C Virus Infection
title_fullStr Splenic Arterial Pulsatility Index to Predict Hepatic Fibrosis in Hemodialysis Patients with Chronic Hepatitis C Virus Infection
title_full_unstemmed Splenic Arterial Pulsatility Index to Predict Hepatic Fibrosis in Hemodialysis Patients with Chronic Hepatitis C Virus Infection
title_short Splenic Arterial Pulsatility Index to Predict Hepatic Fibrosis in Hemodialysis Patients with Chronic Hepatitis C Virus Infection
title_sort splenic arterial pulsatility index to predict hepatic fibrosis in hemodialysis patients with chronic hepatitis c virus infection
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10004191/
https://www.ncbi.nlm.nih.gov/pubmed/36902807
http://dx.doi.org/10.3390/jcm12052020
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