The Japanese Journal of Clinical Dialysis Vol.18 No.6(11)

Theme Disease of Liver, Gallbladder, Spleen, and Pancreas in Dialysis Patients
Title Check points of laboratory findings about hepatobiliary and pancreatic diseases for chronic dialysis patients
Publish Date 2002/06
Author Takayuki Koyama Second Department of Internal Medicine, Shinshu University School of Medicine
Author Kazuhiko Hora Division of Artificial Kidney, Shinshu University School of Medicine
[ Summary ] When we evaluate the laboratory findings for patients undergoing chronic dialysis, we must take care that the cut off points are different from those of non-dialysis patients in several examinations. Concerning the laboratory findings for the liver, biliary tract, and pancreas, it is possible to use the same cut off points in ALP, LDH, gammma-GTP, and AFP even in chronic dialysis patients. But in chronic dialysis patients, we must consider that the level of ALP also reflects renal osteodystrophy, or AFP is mildly elevated by using erythropoietin. It is well known that serum transaminase values are quite low in patients undergoing chronic dialysis; even in non-dialyzed patients of chronic renal failure. Lower serum transaminase values are followed by higher serum creatinine values. Therefore, normal transaminase values in chronic dialysis patients are not always equal no liver disease. Inversely, serum amylase values are high in patients undergoing dialysis, and acute pancreatitis should be suspected when serum amylase values are over three times higher than normal cut off points or P-Amy>80%. Because examinations have no obvious cut off points for chronic dialysis patients, we must evaluate the data from the various view points including other laboratory findings or images.
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