EVALUATION OF HEPATIC ENZYMES IN LIBYAN CHRONIC KIDNEY DISEASE PATIENTS: NEED FOR LOWER STANDARD "NORMAL" RANGE.

Abstract

Chronic Kidney disease (CKD) patients on hemodialysis treatment are at higher risk of hepatitis C infection and they showed lower serum levels of aminotransferases than general population. These hepatic enzymes aid in the diagnosis, monitoring, and treatment of hepatic diseases. The present study aimed to estimate the changes in serum ALT, AST and ALP levels in both predialysis (PreHD-CKD) and hemodialysis (HD-CKD) patients in comparison to normal controls and to find out the association between hepatic enzyme changes and estimated Glomerular Filtration Rate (eGFR). The present study included 53 HD-CKD patients, 61 PreHD-CKD patients, and 50 healthy controls. A questionnaire that included variables was answered by all the participants, and Blood samples were collected and estimated for blood urea, creatinine, AST, ALT, and ALP using standard methods afterward, the data was statistically analyzed using SPSS software. Our results revealed lower AST and ALT levels in HD-CKD patients than both PreHD-CKD patients and healthy controls. On the contrary, ALP was significantly higher in both groups of CKD patients when compared to healthy controls. In addition, no significant correlation has been found between eGFR and hepatic enzymes. Serum ALT and AST levels tend to be reduced in CKD patients on hemodialysis treatment, a finding that enforces the urgent need for the establishment of separate reference ranges of hepatic enzymes 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 CKD patients.