الفهرس 
Liverfuncation testsOnly 14 pages are availabe for public view
 |  | from | 197 |  |  |
| | | from | 197 | | |
Abstract
Serum aninotransferase values are somemnes depressed (e.g. by IQ-.
20%) in 1O~90%of dialysis patieats, Many expJanations have been advaaced,
including inhibition of transamilllase activity by uremic toxins and deficiency
of pyridoxal phosphate (Chang et at.. J 976).
Serum AST values have been shown, to increase after dialysis; the
lncrease is presumed to be due to either to removal of diblyzable inhibitor or
increased release of the enzyme from erythrocytes in the extraeorpoeeal
cu-culatiOJ:\ (Cohen. 1976).
Because of the low baseline serum mniootransferase levels in dialysis
patients, the finding ora value slightly above the upper limits of Donnat, or of
a substantial rise within the llOllDal range, sbould alert the clinician to a
possible underlying disease process (MandeJli, J 991).
A commonelimcal problem is to evaluate the importance of mildly
elevated anlinotrans€erase levels in a dialysis patient. The elevated
aminotransferase levels in dialysis patients must be considered to reOeer
possible viral hepatitis (B andlor C) until proved otherwise, herpes simplex
hepatitis, adenovirus hepatitis or CytOlllCgalOMS hepatitis also will present
with etevatedaminotransferases (AST > ALT). Other causes of elevation of
theseenzyme.s include the effect of hepatotoxic drugs aad iron overload as
reflected by high serum ferritin level (Stanbo-ug/t 1984).