Liver disease vs systemic inflammation in haemodialysis patients.

Sir, The direct association between elevated liver enzymes and serumC-reactive protein (CRP) was recently reported in subjects withmetabolic syndrome [1]. This indicates that even mild liverdisease contributes to generalized low-grade inflammation and,in consequence, may enhance cardiovascular risk. Chronic inflammationis common in patients undergoing maintenance haemodialysis (HD)therapy, and deleteriously underlies the progression of malnutritionand atherosclerosis [2]. Renal failure is also an instructivemodel of the metabolic syndrome, with its harmful effects onboth the cardiovascular system and liver [2]. In addition, chronicviral hepatitis may affect