Diagnostic Accuracy of Noninvasive Tests to Detect Advanced Hepatic Fibrosis in Patients With Hepatitis C and End-Stage Renal Disease

Non-Invasive Assessment of Liver Fibrosis and Steatosis in End-Stage Renal Disease Patients Undergoing Renal Transplant Evaluation

“…Rising ALT levels have been directly associated with severity of hepatic fibrosis in patients with chronic HCV with and without ESRD [ 9 , 35 , 36 ]. We have previously demonstrated that diagnostic accuracy of non-invasive test is dependent on ALT levels in ESRD patients with chronic HCV infection [ 22 ]. These findings question the utility of non-invasive tests in ESRD that solely rely on laboratory values and anthropometric data for assessment of underlying hepatic fibrosis.…”

“…All patients were also being evaluated for renal transplant and had non-invasive testing as part of pre-transplant evaluation. Given the poor performance of serum-based tests in those with chronic HCV in those with ESRD [ 22 ], both serum- and imaging-based tests were used by our center. Non-invasive tests were identified using a PubMed Search and the selected models were free of additional cost and used routinely available laboratory data.…”

“…Unlike imaging-based TE, serum-based non-invasive tests depend on laboratory parameters including ALT level that tends to be normal in patients with CKD and decrease further with worsening severity of disease [ 21 ]. Non-invasive serum-based tests including AST to platelet ratio index (APRI) and Fibrosis-4 (FIB-4) scores have shown variable diagnostic accuracy for advanced fibrosis dependent on ALT levels in patients with hepatitis C virus (HCV) infection and ESRD [ 22 ]. Furthermore, due to normal ALT levels the prevalence of NAFLD in ESRD is unknown and the impact of ALT normalization on non-invasive fibrosis assessment is unclear.…”

Development and validation of a transcriptional signature for the assessment of fibrosis in organs

“…Fibrosis in organs should be adequately assessed, which is valuable for the monitoring and surveillance of patients. Fibrosis in organs such as liver and lung can be assessed with either invasive biopsy or non-invasive methods [7, 8]. Nevertheless, current methods still have many limitations, which may impede their use in monitoring disease severity or progression.…”

Noninvasive Tests to Detect Advanced Fibrosis in Patients With Hepatitis C and End-Stage Renal Disease: Ready for Primetime?

“…We read with great interest the article by Schmoyer et al 1 It is a retrospective study that evaluated the accuracy of noninvasive tests in identifying advanced hepatic fibrosis among patients with chronic hepatitis C virus (HCV) and end-stage renal disease (ESRD). The authors found that in patients with elevated alanine aminotransferase (ALT), the aspartate aminotransferase (AST)-platelet ratio index (APRI), King's score, and FIB-4 score identified patients with advanced fibrosis.…”