Liver Metabolic Function of Hemodialysis Patients With Surface Antigen-Positive Hepatitis B.

Abstract

Hepatitis B virus remains a serious problem, particularly for patients with end-stage renal disease on maintenance hemodialysis. This study sought to investigate the levels of serum cholestasis markers in hepatitis B virus-positive patients on maintenance hemodialysis. This study included 50 hepatitis B virus-positive hemodialysis patients (aged 45.4 ± 4.1 years). All patients had been receiving hemodialysis (because of end-stage renal disease) from 2008 to 2009 at the "MedServis" Private Medical Center in Baku, Azerbaijan. We studied serum gamma-glutamyl transpeptidase and alkaline phosphatase levels after the admission (baseline levels) and after 1, 3, and 6 months of beginning of hemodialysis (or observation for control groups-2). The control groups consisted of hepatitis B virus-negative hemodialysis patients (control group-1) and hepatitis B virus-positive patients with end-stage renal disease not requiring hemodialysis (control group-2). After 1 and 3 months of hemodialysis, serum gamma-glutamyl transpeptidase and alkaline phosphatase levels gradually declined but remained elevated in hepatitis B virus-positive hemodialysis patients compared to control group-1 and control group-2 patients. After 1 month gamma-glutamyl transpeptidase levels in hepatitis B virus-positive hemodialysis patients were 67.9% lower than baseline levels (P0 < .05), were 51.6% higher compared to control group-2 patients (P1 < .05) and did not differ from control group-1 patients (at the same time points). By month 6, serum alkaline phosphatase levels in hepatitis B virus-positive hemodialysis patients had become 53.9% lower than baseline (P < .01), and did not differ from control group-1 and control group-2 patients. The data obtained in this study suggest that hemodialysis may have a positive effect on cholestasis in end-stage renal disease patients with hepatitis B virus infection, and may increase immune response and improve liver function in this group of patients.