Evaluation of Liver Enzymes in End-Stage Renal Disease Patients on the Renal Transplant-Waiting List in North-West of Iran

Sabouri, Samaneh; Aghaee, Monavar Afzal; Lotfi, Zahra; Esmaily, Habibollah; Alizadeh, Maryam; Mozafari, Hooman Mosannen

doi:10.5812/numonthly.107859

Cited by 4 publications

(6 citation statements)

References 16 publications

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“…This is shown in Table 7. In the previous studies, patients having dialysis for the long time were found to have transaminases level in the serum close to the normal ranges 8 . Transaminases levels were found to be reduced in pre-dialysis patients of chronic kidney disease, the level of AST was investigated 9 .…”

Section: Resultsmentioning

confidence: 91%

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Relationship Between Liver Function Tests & Cardiovascular Risk Factors in Stage 3-5 Pre-Dialysis Chronic Kidney Disease

Rehman¹,

Khan²,

Khattak³

et al. 2022

PJMHS

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Objectives: The main objective of this study was to evaluate the relation between liver function tests and biochemical cardiovascular risk factors in chronic kidney disease patients. Methodology: this study was conducted in Khyber Teaching Hospital Peshawar, from Ist May 2022 till 31st Oct, 2022. 250 patients in total were included in this study. All the people included in this study were chronic kidney disease patients at pre dialysis stage 3 to 5. Data collected included demographic information, liver function tests and biochemical cardiovascular risk factors. CKD-EPI equation was used to calculate glomerular filtration rate. Results: This study resulted in ALT being negatively correlated with C reactive protein and intact level of parathyroid hormone and positively correlated with glomerular filtration rate, triglyceride, calcifediol and albumin. Gamma-glutamyl transferase was negatively correlated with HDL cholesterol and positively correlated with glomerular filtration rate, triglycerides and C reactive protein. AST was negatively correlated with C reactive protein and intact level of parathyroid hormone and positively correlated with glomerular filtration rate, HDL cholesterol, albumin and calcifediol. In diabetic patients AST and ALT were positively correlated with glomerular filtration rate, additionally AST was also positively correlated with HDL cholesterol but negatively with intact parathyroid hormone. Gamma-glutamyl transferase had no correlation. In total population of the study and in diabetic group correlation analysis was run between glomerular filtration rate and biochemical cardiovascular risk factors, it resulted in GFR being negatively correlated with albuminuria, C reactive protein and intact parathyroid hormone and positively correlated with triglyceride, calcifediol and albumin. A partial correlation analysis, controlled for GFR, was also run between cardiovascular risk factors and LFTs. It resulted in no correlation between both. Practical implication: this study could be useful when planning the treatment of CKD patients with cardiovascular risk factors. Also in predicting the risk of cardiovascular disease in CKD patients based on the LFTs. It could also help initiate further reseach on related topics like the role of LFTs in predicting cardiovascular disease in CKD patients. Conclusion: this study concluded that relation between liver function tests and biochemical cardiovascular risk factors in chronic kidney disease patients could be the function of compromised glomerular filtration rate. Keywords: cardiovascular risk factors, chronic kidney disease, aspartate transaminase, gamma-glutamyl transferase, alanine transaminase

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Section: Resultsmentioning

confidence: 91%

“…In case of chronic kidney disease, uremic toxins increases in the blood. This causes decreased production of transaminases from the hepatocytes 8,9 . GGT resulted in being independent foretelling indicator of cardiovascular disease.…”

Section: Resultsmentioning

confidence: 99%

Relationship Between Liver Function Tests & Cardiovascular Risk Factors in Stage 3-5 Pre-Dialysis Chronic Kidney Disease

Rehman¹,

Khan²,

Khattak³

et al. 2022

PJMHS

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“…Other possibilities included decreased synthesis and inhibition of release of AST and ALT from hepatocytes or accelerated clearance from serum. [13][14][15][16] A low serum aminotransferase level could also be due to water retention and hemodilution in patients of CKD. 10 However, this pattern is usually not maintained in CKD with COVID-19.…”

Section: Resultsmentioning

confidence: 99%

An Evaluation of Liver Function Tests in SARS-CoV-2 infection in the backdrop of chronic kidney disease

Kumar

Jana

Priyadarshini

et al. 2021

Preprint

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INTRODUCTION The SARS-CoV-2 pandemic has emerged as perhaps the most challenging global health problem of this century. The concomitant presence of co morbidities like chronic kidney disease (CKD), diabetes, chronic heart disease etc. makes the task of patient management difficult. AIMS AND OBJECTIVES To assess the patterns of liver test abnormalities in patients of COVID 19 infection with and without CKD and evaluate the probable outcomes. MATERIALs and METHODS A cross-sectional retrospective observational study done on 600 patient samples (Group 1 COVID-19 without CKD, Group 2 COVID-19 with CKD and Group 3 non COVID-19 with CKD) which were processed for Liver function test (AST, ALT and ALP) and Renal function test (Urea and Creatinine) in the Department of Biochemistry, Dr. RML Hospital New Delhi. RESULTS AST and ALT levels were significantly higher (P < 0.05) in all COVID 19 positive patients group 1 mean and 2 SD, (63.63 and 42.89 U/L & 50.25 and 46.53 U/L respectively) and group 2 (90.59 and 62.51 U/L & 72.09 and 67.24 U/L respectively) as compared to Group 3 (25.24 and 7.47 U/L & 24.93 and 11.44 U/L respectively) and also a statistically significant elevation is seen in these two parameters (AST & ALT) in Group 2 as compared to Group 1 (P < 0.05). There was a negative significant correlation between eGFR and AST/ALT levels in Group 1 (p < 0.05). In Group 2, a weak positive correlation was seen with ALT (p < 0.01). No significant correlation existed between eGFR and ALP in groups 1 and 2. In Group 3, eGFR showed strong correlations with AST and ALT levels (p < 0.01) and reduction in kidney function correlated well with increase in serum ALP levels, (p < 0.01). CONCLUSIONS This study most comprehensively describes that SARS-CoV-2 positive CKD patients show more elevations in serum aminotransferase levels as compared to their non-CKD counterparts, in contrast to non-COVID-19 CKD cases. Serum ALT values in SARS-CoV-2 patients show significant correlation with calculated eGFR values. Elevated ALP values in CKD patients may be used as an indicator of declining kidney function. However, more studies in this direction are needed.

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“…[ 10 ] Other possibilities included decreased synthesis and inhibition of release of AST and ALT from hepatocytes or accelerated clearance from serum. [ 12 13 14 15 16 ] A low serum amino-transferase level could also be due to water retention and hemodilution in patients of CKD. [ 10 ] However, this pattern is usually not maintained in CKD with SARS-CoV-2.…”

Section: Discussionmentioning

confidence: 99%

“…[ 10 ] and Sabouri et al . [ 16 ] have emphasized that the use of standard reference values for amino-transferases to help detect liver disease, is less useful in CKD patients, and have proposed that separate normal (lower) reference ranges of serum aminotransferases in different stages of CKD need to be determined. However, in stark contrast to their findings there is a paradigm shift with respect to serum ALT/AST levels in SARS-CoV-2 afflicted CKD patients, who show elevations from baseline levels that lie beyond normal conventional laboratory ranges.…”

Section: Discussionmentioning

confidence: 99%

An evaluation of liver function tests in severe acute respiratory syndrome - Corona virus 2 (SARS-CoV-2) infection in the backdrop of chronic kidney disease

Roy

Kumar

Jana

et al. 2022

Journal of Family Medicine and Primary Care

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Background: The SARS-CoV-2 pandemic has emerged as the most challenging global health problem of this century. The concomitant presence of co-morbidities like chronic kidney disease (CKD), diabetes, CHD, further complicates the problem. Aim: To assess the patterns of LFT abnormalities in patients of SARS-CoV-2 infection with and without CKD and evaluate the probable outcomes. Materials and Methods: A cross-sectional retrospective observational study done on 600 patient samples (Group 1: SARS-CoV-2 without CKD, Group 2: SARS-CoV-2 with CKD and Group 3: CKD uninfected with SARS-CoV-2) which were processed for LFT and KFT. Results: AST and ALT were significantly higher in all SARS-CoV-2 infected; Group 1 mean ± 2SD, (63.63 ± 42.89U/L & 50.25 ± 46.53U/L), group 2 (90.59 ± 62.51U/L & 72.09 ± 67.24 U/L) as compared to Group 3 (25.24 ± 7.47U/L & 24.93 ± 11.44U/L). A statistically significant elevation is seen in these two parameters in Group 2 as compared to Group 1. There was a negative significant correlation between eGFR and AST/ALT levels in Group 1 ( p < 0.05). In Group 2, a weak positive correlation was seen with ALT. Group 3, eGFR’s showed strong correlations with AST and ALT levels; reduction in kidney function correlated well with increase in serum ALP levels. Conclusions: This study establishes that SARS-CoV-2 infected, with CKD, show higher elevations in serum aminotransferase levels in comparison to those without CKD. In contrast, the CKD group not infected, shows a decline in serum aminotransferase levels. Serum ALT values in SARS-CoV-2 show significant correlation with eGFR. Also, elevated ALP values in CKD patients may be used as an indicator of declining kidney function.

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Evaluation of Liver Enzymes in End-Stage Renal Disease Patients on the Renal Transplant-Waiting List in North-West of Iran

Cited by 4 publications

References 16 publications

Relationship Between Liver Function Tests & Cardiovascular Risk Factors in Stage 3-5 Pre-Dialysis Chronic Kidney Disease

Relationship Between Liver Function Tests & Cardiovascular Risk Factors in Stage 3-5 Pre-Dialysis Chronic Kidney Disease

An Evaluation of Liver Function Tests in SARS-CoV-2 infection in the backdrop of chronic kidney disease

An evaluation of liver function tests in severe acute respiratory syndrome - Corona virus 2 (SARS-CoV-2) infection in the backdrop of chronic kidney disease

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