Liver enzymes in patients with chronic kidney disease undergoing peritoneal dialysis and hemodialysis

Abstract

OBJECTIVE:The present study was designed to analyze the serum levels of aspartate and alanine aminotransferases, gamma-glutamyl transferase, and the hematocrit in patients with chronic kidney disease who were undergoing peritoneal dialysis or hemodialysis.PATIENTS AND METHODS:Twenty patients on peritoneal dialysis and 40 on hemodialysis were assessed, and the patients were matched according to the length of time that they had been on dialysis. Blood samples were collected (both before and after the session for those on hemodialysis) to measure the enzymes and the hematocrit.RESULTS:In the samples from the patients who were undergoing peritoneal dialysis, the aspartate and alanine aminotransferase levels were slightly higher compared with the samples collected from the patients before the hemodialysis session and slightly lower compared with the samples collected after the hemodialysis session. The levels of gamma-glutamyl transferase in the hemodialysis patients were slightly higher than the levels in the patients who were undergoing peritoneal dialysis. In addition, the levels of aminotransferases and gamma-glutamyl transferase that were collected before the hemodialysis session were significantly lower than the values collected after the session. The hematocrit levels were significantly lower in the patients who were on peritoneal dialysis compared with the patients on hemodialysis (both before and after the hemodialysis session), and the levels were also significantly lower before hemodialysis compared with after hemodialysis.CONCLUSION:The aminotransferase levels in the patients who were undergoing peritoneal dialysis were slightly higher compared with the samples collected before the hemodialysis session, whereas the aminotransferase levels were slightly lower compared with the samples collected after the session. The hematocrits and the aminotransferase and gamma-glutamyl transferase levels of the samples collected after the hemodialysis session were significantly higher than the samples collected before the session. Taken together, the present data suggest that hemodilution could alter the serum levels of liver enzymes.

Non-Alcoholic Fatty Liver Disease Proven by Transient Elastography in Hemodialysis Patients: Is It a New Risk Factor for Adverse Cardiovascular Events?

“…So, recognition of liver damage may be hampered by the reduction in aminotransferase values in HD patients. Possible underlying reasons may be related to pyridoxine deficiency or maybe by the presence of an inhibitory substance in the uremic milieu, but the exact mechanism is still unknown [18]. The evaluation of liver fibrosis/steatosis by non-invasive methods such as TE may represent a potential future approach to the non-invasive assessment of liver steatosis/fibrosis in HD patients.…”

Association between Aminotransferase/alanine Aminotransferase Ratio and Cardiovascular Disease mortality in Patients on Peritoneal Dialysis

“…Decreased ALT resulted from a reduced liver size and liver blood ow and was associated with aging, frailty, and higher mortality in the general elderly population [26,27]. There is a correlation between ALT levels and the severity of renal failure [15].…”

“…Patients on dialysis had reduced serum levels of aminotransferases, which suggested that the ALT levels were reduced concomitantly with the progression of renal dysfunction [14,15]. Previous study demonstrated that ALT levels have a negative correlation with the severity of renal failure, resulting in high AST/ALT ratio in PD patients.…”

“…Another study from the United Kingdom showed that elevated AST/ALT ratio is signi cantly associated with an increased risk of developing CVD in men with no history of CVD at baseline [13]. It was noteworthy that patients on dialysis had reduced serum levels of aminotransferases [14,15], whereas whether the AST/ALT ratio was an independent predictor of CVD mortality in dialysis patients remains unknown. In the present study, the aim of this study was to evaluate the association between the AST/ALT ratio and CVD mortality in PD patients.…”

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

“…There was in one study an increase in the sensitivity of ALT from 55% to 76% for the diagnosis of discrete liver diseases and specificity was reduced from 97% to 89% when the ULN was reduced [11,12]. A second study found the risk of mortality from liver disease was higher in individuals with normal levels of ALT that were close to the ULN compared with individuals with lower ALT levels in a large Korean population.…”