End-stage renal disease and hepatitis C infection: comparison of alanine aminotransferase levels and liver histology in patients with and without renal damage.
OBJECTIVE
To what extent the serum levels of alanine aminotransferase (ALT) are related to histological characteristics of liver damage caused by hepatitis C virus (HCV) infection among patients with end-stage renal disease (ESRD) remains unclear.


METHODS
Patients with a positive anti-HCV antibody titer confirmed by supplemental tests were evaluated by liver biopsy. We compared ALT levels in patients with and without renal damage, with similar histological grades and stages of inflammation and fibrosis. Results: Patients were divided into two groups: patients with ESRD (n = 25) and patients without ESRD renal damage (n = 39).


RESULTS
The ALT level was 42.1 +/- 24.3 IU/L for the ESRD group, compared with 109.9 +/- 55.8 IU/L for the non-ESRD group (P < 0.001). Liver inflammation (modified Knodell grade) was 4.0 +/- 2.1 in the ESRD group versus 5.2 +/- 2.4 in the non- ESRD group; fibrosis (6-point scale) was 1.1 +/- 1.2 versus 1.7 +/- 1.5, respectively.


CONCLUSIONS
Despite histological evidence of liver inflammation, ALT levels in the ESRD group were normal, while ALT levels were significantly higher in the non-ESRD group with similar levels of liver inflammation. In conclusion, ALT levels are not a useful indicator of HCV infection in patients with ESRD and liver biopsies should be recommended for kidney transplant candidates.
Contreras
Ana M
AM
Jalisco State Coordination of Health Research, Instituto Mexicano del Seguro Social. Guadalajara, México. acontreras53@hotmail.com
Ruiz
Isaac
I
Polanco-Cruz
Gisela
G
Monteón
Francisco J
FJ
Celis
Alfredo
A
Vázquez
Gonzalo
G
Gómez-Herrera
Efraín
E
García-Correa
Jesús E
JE
Male-Velázquez
René
R
Ruelas-Hernández
Sara
S
D000328:Adult; D000410:Alanine Transaminase / Q000378:metabolism*; D001706:Biopsy; D005260:Female; D005500:Follow-Up Studies; D016174:Hepacivirus / Q000235:genetics / Q000276:immunology; D006526:Hepatitis C / Q000150:complications / Q000201:enzymology / Q000473:pathology; D018937:Hepatitis C Antibodies / Q000032:analysis; D006801:Humans; D007124:Immunoenzyme Techniques; D007676:Kidney Failure, Chronic / Q000150:complications* / Q000201:enzymology / Q000473:pathology; D008099:Liver / Q000201:enzymology / Q000473:pathology; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D012367:RNA, Viral / Q000032:analysis; D012189:Retrospective Studies; D012720:Severity of Illness Index
D018937:Hepatitis C Antibodies; D012367:RNA, Viral; D000410:Alanine Transaminase