The Effects of Chronic Kidney Disease on Liver Function Tests: The Laboratory Interpretation Perspective

Abstract

The aim of the study was to determine the levels of routinely measured liver function tests such as liver enzymes (AST, ALT, ALP, GGT & LDH), serum proteins (albumin and total) and serum bilirubins in patients with Chronic Kidney Disease (CKD). Clinical management of CKD involves frequent laboratory monitoring of liver function tests. It is therefore important to understand the levels of these biochemistry parameters in both healthy individuals and those with CKD for easier and accurate interpretation. A cross-sectional study of two groups of study subjects including patients with CKD and control group was used. A total of 180 subjects with CKD were recruited for the study plus another 200 healthy subjects who served as the control group and were recruited from among blood donors. About 2.0 mL of venous blood specimen was removed from each patient and from control subjects. Levels of the enzymes Aspartate Transaminase (AST), Alkaline Phosphatase (ALP), Alanine Transaminase (ALT), Gamma Glutamyl Transferase (γ-GT) and Lactate Dehydrogenase (LDH) were measured. Levels of serum protein and bilirubin were also determined in the two groups of study subjects. The Kolmogrov-Smirnov test was used to test the data for normality. The data obtained was parametric in nature and was tabulated as a mean and standard deviation. Parametric method of data analysis was used. Descriptive statistics used included parameters of location and parameters of dispersion. Means differences between investigated groups (control and chronic kidney disease patients) were assessed by ANOVA and post Anova statistical analysis. There were statistically significant differences (p<0.05) in the levels of serum protein and liver enzymes between patients with CKD and control group but no significant differences in the levels of serum bilirubin (p>0.05). The results suggest that those patients with CKD exhibited low levels of AST and ALT while the levels of ALP, GGT, and LDH were relatively higher. The levels of serum proteins were relatively lower in patients with CKD as compared to the control group. There is, therefore, the need for a keen interpretation of liver function tests in patients suffering from CKD.