Table of Contents

2018 Month : April Volume : 7 Issue : 16 Page : 1949-1954

HEPATIC ENZYMES CHANGES IN CHRONIC KIDNEY DISEASE PATIENTS- A NEED FOR MODIFIED REFERENCE VALUES.

Omar B. Latiwesh1, Mustafa Y. G. Younis2, Srikumar Shakila3, Fatima Abdulmalik4, Jamal A. Alammari5, Yupa Min6, Azhar Hussain7, Jagannadha Rao Peela8

Corresponding Author:
Mustafa Y. G. Younis,
Assistant Professor,
HOD of Biochemistry,
University of Benghazi, Benghazi, Libya.
E-mail: jagannadh21@yahoo.co.uk

ABSTRACT

BACKGROUND

Aspartate aminotransferase (AST), alanine aminotransferase (ALT) and alkaline phosphatase (ALP) are markers of aggression to hepatocytes and aid in the diagnosis, monitoring and treatment of liver diseases because they reflect the inflammatory activity of the liver. The present study aimed to estimate the changes in serum ALT, AST and ALP levels in both pre-dialysis (pre-HD-CKD) and haemodialysis (HD-CKD) patients in comparison to healthy controls, and to find out the association between hepatic enzyme changes and estimated Glomerular Filtration Rate (eGFR), body weight loss, duration of disease and duration of haemodialysis in CKD patients.

MATERIALS AND METHODS

The present descriptive comparative study conducted on 53 HD-CKD patients, 61 pre-HD-CKD patients and 50 healthy controls. The clinical information and medical history were obtained through the review of patient’s medical files and patient’s interviews. A face-to-face interview was conducted based on a questionnaire that included variables such as age, sex, date of the diagnosis, cause of the disease, blood pressure, height, weight, duration of haemodialysis and any health problems or prescriptions. Blood samples were collected from all the participants and analysed for urea, creatinine, AST, ALT and ALP using fully automated machines. The data were statistically analysed using SPSS software and p-value less than 0.05 was considered as statistically significant.

RESULTS

Our results revealed lower AST and ALT levels in HD-CKD patients than both pre-HD-CKD patients and healthy controls. On the contrary, the difference in aminotransferase level between pre-HD-CKD patients and control was statistically non-significant. Moreover, ALP was significantly higher in both groups of CKD patients when compared to healthy controls. In addition, a significant negative correlation has been shown between blood urea and aspartate aminotransferase level in pre-HD-CKD group.

CONCLUSION

Serum ALT and AST levels tend to be reduced in CKD patients, particularly in those on maintenance haemodialysis treatment, a finding that enforces the urgent need for the establishment of separate reference ranges of liver function tests for CKD patients in order to facilitate the diagnosis, monitoring and treatment of liver diseases, especially hepatitis C infection, an establishment that may play a role in decreasing the mortality in the CKD patients.

KEYWORDS

Hepatic Enzymes, Chronic Kidney Disease, AST, ALT, ALP.

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