| Theme |
New Perspectives of Molecular Biomarker in Dialysis Therapy |
| Title |
Useful molecular biomarkers for concerning liver disease in hemodialysis patients |
| Author |
Teiji Kuzuya |
Division of Gastroenterology and Hepatology, Musashino Red Cross Hospital |
| Author |
Namiki Izumi |
Division of Gastroenterology and Hepatology, Musashino Red Cross Hospital |
| [ Summary ] |
Hemodialysis patients exhibit a susceptibility to hepatitis C virus (HCV) and hepatitis B virus (HBV) infections with a higher rate of incidence than the general population. Therefore, it is important for hemodialysis patients that we examine molecular biomarkers for hepatitis virus infections and hepatocellular carcinoma (HCC). First, routine serologic testing for HCV and HBV infection markers should be conducted. HBs-Ag and HCV-AB should be examined regularly also. If HBs-Ag or HCV-AB tests are positive, HCV-RNA or HBV-DNA should be examined to diagnose viral hepatitis. Generally, the level of serum alanine aminotranferase (ALT) in hemodialysis patients is lower than that in the general population. However, even if the level of serum ALT shows mild abnormalities in hemodialysis patients with chronic hepatitis infection, these patients may have accompanying inflammation and/or liver fibrosis. The tumor markers indicating HCC are alpha-fetoprotein (AFP), Lens culinaris agglutinin-reactive fraction of alpha-fetoprotein (AFP-L3) and proteins induced by lack of vitamin K or antagonist-II (PIVKA-II). Normal ranges of these three tumor markers in hemodialysis patients are the same as those observed in the general population. It is important for early detection of the development of liver cirrhosis or the occurrence of HCC that we examine these molecular biomarkers regularly even if hemodialysis patients have no symptoms. |