Cargando…
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...
Autores principales: | , , , , , , , , |
---|---|
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 |
_version_ | 1784904772053106688 |
---|---|
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. |
format | Online Article Text |
id | pubmed-10004191 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2023 |
publisher | MDPI |
record_format | MEDLINE/PubMed |
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 |
work_keys_str_mv | AT liuchenhua splenicarterialpulsatilityindextopredicthepaticfibrosisinhemodialysispatientswithchronichepatitiscvirusinfection AT fangyujen splenicarterialpulsatilityindextopredicthepaticfibrosisinhemodialysispatientswithchronichepatitiscvirusinfection AT liuchunjen splenicarterialpulsatilityindextopredicthepaticfibrosisinhemodialysispatientswithchronichepatitiscvirusinfection AT sutunghung splenicarterialpulsatilityindextopredicthepaticfibrosisinhemodialysispatientswithchronichepatitiscvirusinfection AT huangshangchin splenicarterialpulsatilityindextopredicthepaticfibrosisinhemodialysispatientswithchronichepatitiscvirusinfection AT tsengtaichung splenicarterialpulsatilityindextopredicthepaticfibrosisinhemodialysispatientswithchronichepatitiscvirusinfection AT wujohsuan splenicarterialpulsatilityindextopredicthepaticfibrosisinhemodialysispatientswithchronichepatitiscvirusinfection AT chenpeijer splenicarterialpulsatilityindextopredicthepaticfibrosisinhemodialysispatientswithchronichepatitiscvirusinfection AT kaojiahorng splenicarterialpulsatilityindextopredicthepaticfibrosisinhemodialysispatientswithchronichepatitiscvirusinfection |