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. 2023 Oct 1;30(4):260-267.
doi: 10.4078/jrd.2023.0032. Epub 2023 Aug 31.

Hepatic steatosis index at diagnosis has the potential for forecasting end-stage kidney disease in patients with antineutrophil cytoplasmic antibody-associated vasculitis

Hyun Joon Choi #  1 , Pil Gyu Park #  2 , Yong-Beom Park  3   4 , Ji Hye Huh  5 , Sang-Won Lee  1 , Ph D  3   4
Affiliations

Hepatic steatosis index at diagnosis has the potential for forecasting end-stage kidney disease in patients with antineutrophil cytoplasmic antibody-associated vasculitis

Hyun Joon Choi et al. J Rheum Dis. .

Abstract

Objective: This study evaluated whether the hepatic steatosis index (HSI) at antineutrophil cytoplasmic antibody-associated vasculitis (AAV) diagnosis could forecast poor outcomes during the disease course in AAV patients.

Methods: This study included 260 AAV patients. The equation for HSI is as follows HSI=8×(alanine aminotransferase/aspartate aminotransferase)+body mass index+(2, diabetes mellitus)+(2, female). The cut-off of HSI was obtained using the receiver operating characteristic curve.

Results: The median age of the 260 patients was 59.5 years, and 65.0% were female. Among the continuous variables excluding the parameters composing the equation for HSI, HSI was significantly correlated with Birmingham vasculitis activity score, five-factor score, haemoglobin, blood urea nitrogen, serum creatinine, and total cholesterol. Among poor outcomes, the area under the curve of HSI for end-stage renal disease (ESRD) was significant, and the cut-off of HSI for ESRD was set at ≤30.82. AAV patients with HSI ≤30.82 exhibited a significantly higher risk of ESRD (relative risk 3.489) and a significantly lower cumulative ESRD-free survival rate than those with HSI >30.82.

Conclusion: This study is the first to demonstrate that HSI at AAV diagnosis could forecast ESRD during the disease course in AAV patients.

Keywords: Antineutrophil cytoplasmic antibody; End-stage renal disease; Forecasting; Hepatic steatosis index; Vasculitis.

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Conflict of interest statement

CONFLICT OF INTEREST No potential conflict of interest relevant to this article was reported.

Figures

Fig. 1
Fig. 1
Receiver operator characteristic curve analysis. Among five poor outcomes of antineutrophil cytoplasmic antibody-associated vasculitis, only hepatic steatosis index (HIS) for ESRD showed statistical significance (area under the curve 0.333 for the presence of ESRD, p<0.001 and 0.670 for the absence of ESRD, p<0.001). The optimal cut-off of HSI for ESRD was set at ≤30.82. CI: confidence interval, CVA: cerebrovascular accident, ACS: acute coronary syndrome, ESRD: end-stage renal disease.
Fig. 2
Fig. 2
Relative risk for ESRD. Antineutrophil cytoplasmic antibody-associated vasculitis patients with HSI ≤30.82 exhibited a significantly higher risk of progression to ESRD than those with HSI >30.82. ESRD: end-stage renal disease, HSI: hepatic steatosis index.
Fig. 3
Fig. 3
Cumulative ESRD-free survival rates. Antineutrophil cytoplasmic antibody-associated vasculitis patients with HSI ≤30.82 exhibited a significantly lower cumulative ESRD-free survival rate than those with HSI >30.82 (p=0.001). ESRD: end-stage renal disease, HSI: hepatic steatosis index.
See this image and copyright information in PMC

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