Indian Journal of Medical Biochemistry

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VOLUME 23 , ISSUE 1 ( January-April, 2019 ) > List of Articles

Original Article

Serum Liver and Pancreatic Enzymes in Chronic Kidney Disease with and without End-stage Renal Disease: A Comparative Study

M Manju, Suryapriya Rajendran, Sasmita Mishra, Pavithra M

Keywords : Chronic kidney disease, GFR, Hepatic and pancreatic enzymes

Citation Information : Manju M, Rajendran S, Mishra S, M P. Serum Liver and Pancreatic Enzymes in Chronic Kidney Disease with and without End-stage Renal Disease: A Comparative Study. Indian J Med Biochem 2019; 23 (1):207-212.

DOI: 10.5005/jp-journals-10054-0087

License: CC BY-NC 4.0

Published Online: 01-04-2019

Copyright Statement:  Copyright © 2019; Jaypee Brothers Medical Publishers (P) Ltd.


Abstract

Introduction: Chronic kidney disease (CKD) is emerging as an important chronic disease globally. The occurrence of liver and pancreatic diseases as comorbid conditions is very common. Estimation of liver and pancreatic enzymes still remains the main modality of diagnosis and monitoring hepatic and pancreatic diseases. Alterations in the enzyme levels in the absence of liver and pancreatic diseases have been reported. Hence we decided to compare the serum levels of liver and pancreatic enzymes (AST, ALT, ALP, GGT amylase and lipase) among CKD patients without end-stage renal disease (ESRD), patients with ESRD and healthy controls and to correlate the enzyme levels with eGFR (severity). Materials and methods: The present study was conducted in a tertiary care hospital with 100 controls, 100 CKD patients without ESRD and 100 ESRD patients. All the 300 patients had no evidence of hepatic or pancreatic diseases. Alanine transaminase (AST), aspartate transaminase (ALT), alkaline phosphatase (ALP), gamma-glutamyl transferase (GGT), amylase and lipase were estimated in all 300 study subjects. Results: There was a significant decrease in the levels of AST and ALT and increase in ALP, GGT, amylase and lipase levels in the CKD patients without ESRD and ESRD patients as compared to the controls (p < 0.05). eGFR was found to have a strong negative correlation with ALP, amylase, and lipase in CKD patients without ESRD and with ESRD. Conclusion: Our study emphasizes that, using the present reference ranges for these enzymes in CKD patients will result misdiagnosis of hepatic or pancreatic disease, hence emphasizing the need to establish new reference ranges for these enzymes in various stages of CKD which ultimately will help the treating physicians in diagnosis and management of hepatic and pancreatic dysfunction in CKD patients.


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