Serum Alanine Aminotransferase Levels, Hematocrit Rate and Body Weight Correlations Before and After Hemodialysis Session

Abstract

PURPOSETo evaluate alanine aminotransferase levels before and after a hemodialysis session and to correlate these values with the hematocrit rate and weight loss during hemodialysis.PATIENTS AND METHODSThe serum alanine aminotransferase levels, hematocrit rate and body weight were measured and correlated before and after a single hemodialysis session for 146 patients with chronic renal failure. An receiver operating characteristic (ROC) curve for the serum alanine aminotransferase levels collected before and after hemodialysis was plotted to identify hepatitis C virus-infected patients.RESULTSThe mean weight loss of the 146 patients during hemodialysis was 5.3% (p < 0.001). The mean alanine aminotransferase levels before and after hemodialysis were 18.8 and 23.9 IU/, respectively, denoting a significant 28.1% increase. An equally significant increase of 16.4% in the hematocrit rate also occurred after hemodialysis. The weight loss was inversely correlated with the rise in both the alanine aminotransferase level (r = 0.3; p < 0.001) and hematocrit rate (r = 0.5; p < 0.001). A direct correlation was found between the rise in alanine aminotransferase levels and the hematocrit during the hemodialysis session (r = 0.4; p < 0.001). Based on the ROC curve, the upper limit of the normal alanine aminotransferase level should be reduced by 40% relative to the upper limit of normal if the blood samples are collected before the hemodialysis session or by 60% if blood samples are collected after the session.CONCLUSIONIn the present study, significant elevations in the serum alanine aminotransferase levels and hematocrit rates occurred in parallel to a reduction in body weight after the hemodialysis session. These findings suggest that one of the factors for low alanine aminotransferase levels prior to hemodialysis could be hemodilution in patients with chronic renal failure.

Cytokine elevation and transaminitis after laparoscopic donor nephrectomy

“…The increase in extracellular fluid volume leads to dilution of liver function tests. For example, patients on hemodialysis have been found to have a nearly 50% increase in serum transaminase levels after hemodialysis with removal of up to 5 liters of extracellular fluid (33). As a result, serum cytokines, MCP-1, and transaminases were normalized to change in serum albumin.…”

“…Urine creatinine was measured using colorimetric assay (Thermo Fisher Scientific, Waltham, MA). To allow for comparison between baseline and postoperative values while accounting for the large variances in perioperative hemodilution between patients, serum inflammatory markers and transaminase levels were normalized for hemodilution using a ratio of preoperative albumin to postoperative albumin (22,33,48,50). In addition, levels of urine markers were normalized with urine creatinine to reflect disparities in urine concentration caused by differences in hydration and, potentially, renal injury.…”

Kinetics of Hepatitis B Virus Load During Haemodialysis Sessions and α-Interferon: A Prospective Study

“…The mechanisms underlying the intradialytic drop in HBV viraemia remain to be clarified. One of the factors for low HBV viral load prior to hemodialysis could be hemodilution as recently observed for alanine aminotransferase levels [36]; however, the data reported in Figure 2 are not in keeping with this. In fact, higher levels of HBV DNA at pre-dialysis phase were found in the first dialysis of the week where the hemodilution effect is much greater than at the midweek or end-of week sessions.…”

“…The majority of our patients used high-bicompatibility dialysis filters as low-biocompatibility membanes (i.e., cuprophan) are surpassed in developed world; also, the limited number of patients hampered an appropriate comparison. Third, we have not corrected our results on HBV DNA kinetics by fluid loss during dialysis, as performed by others [36]. In fact, when water is extracted during haemodialysis, the plasma becomes concentrated and content in plasma shows higher concentrations reflected in haematocrit increases.…”

Alterations of Hematological Parameters, Hemoglobin and Hematocrit With Liver Enzymes, Aspartate Transaminase and Alanine Transaminase Among Patients With Chronic Kidney Disease Undergoing Hemodialysis in Aljouf Region, Saudi Arabia

“…Deficiency of vitamin B6, a coenzyme of ALT also may cause lower levels of ALT as does hemodilution, which occurs due to water retention in patients with CKD [9,10].…”