Blood ammonia level in chronic liver disease: clinical and pathogenetic importance

Abstract

Aim. To evaluate blood ammonia concentration in patients with chronic liver diseases. Methods. 87 patients with chronic liver disease were examined. Ammonia concentration was determined using the enzymatic test. Results. Ammonia concentrations ranged from 18.16 to 118.36 μmol/l (median 43.7 μmol/l). Depending on blood ammonia level, 2 groups of patients were identified: with blood ammonia level below (first group) and above the median level (second group). The first group included 35 (79.5%) patients with liver cirrhosis and 9 (20.5%) patients with chronic hepatitis, the numbers were similar in the second group: 36 (83.7%) and 7 (26.3%) patients correspondingly. Signs of portal gastropathy were identified in 25 (58.1%) and 26 (60.5%) patients correspondingly, while Helicobacter pylori infection was found in 5 (21.7%) and 8 (31.8%) patients with blood ammonia level below and above the median level correspondingly. Mean ammonia concentration in patients with liver cirrhosis and chronic hepatitis, with and without portal gastropathy, with mild and severe gastropathy did not differ significantly. Conclusion. Ammonia blood concentration can not reliably indicate liver failure, hepatic encephalopathy development and stage, portal hypertension and collateral development as well as predict gastric lesions.