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

Area of Science:

• Hepatology
• Radiology
• Nephrology

Background:

• Chronic hepatitis C virus (HCV) infection is a leading cause of liver disease in hemodialysis patients.
• Accurate staging of hepatic fibrosis is crucial for managing HCV infection but often requires invasive liver biopsy.
• Noninvasive methods for fibrosis assessment are needed, especially in vulnerable populations like hemodialysis patients.

Purpose of the Study:

• To evaluate the clinical utility of splenic arterial pulsatility index (SAPI) in predicting hepatic fibrosis stages in hemodialysis patients with HCV.
• To compare the diagnostic performance of SAPI with established noninvasive fibrosis indices like FIB-4 and APRI.

Main Methods:

• A retrospective, cross-sectional study included 296 hemodialysis patients with HCV.
• Splenic arterial pulsatility index (SAPI) was assessed using duplex Doppler ultrasonography.
• Liver stiffness measurements (LSMs) were used to determine fibrosis stages and as a reference standard.

Main Results:

• SAPI showed significant positive correlations with LSMs (r=0.413, p<0.001) and fibrosis stages (ρ=0.529, p<0.001).
• SAPI demonstrated good predictive performance for various fibrosis stages (AUROCs ranging from 0.730 to 0.851).
• SAPI's diagnostic accuracy was comparable to FIB-4 and superior to APRI, with high negative predictive values for advanced fibrosis.

Conclusions:

• Splenic arterial pulsatility index (SAPI) is a valuable noninvasive tool for predicting hepatic fibrosis severity in hemodialysis patients with chronic HCV infection.
• SAPI offers a reliable alternative to liver biopsy for fibrosis staging in this patient population.
• Further prospective studies can validate SAPI's role in clinical decision-making for HCV management.