Liver Enzymes in End Stage Renal Disease Patients Diabetic and Non- Diabetic. Does it Differ than General Population?

Abstract

<title>Abstract</title> <bold>Background:</bold> End-stage renal disease (ESRD) often necessitates hemodialysis and is frequently caused by diabetes mellitus (DM). Liver enzyme levels are vital for assessing liver function but are complex to interpret in ESRD patients due to uremia, dialysis, and comorbidities. The effect of DM on liver enzymes in ESRD patients remains unclear. This study aims to evaluate liver enzyme levels in ESRD patients on hemodialysis and determine the impact of ESRD per se on liver enzymes and of ESRD with diabetes mellitus on liver enzymes levels. <bold>Methods:</bold> This cross-sectional study was conducted on 140 participants, divided into ESRD (70 patients) and control (70 healthy individuals) groups. The ESRD group was further classified into diabetic (n=14) and non-diabetic (n=56) subgroups. Laboratory parameters including liver enzymes, serum albumin, bilirubin, urea, creatinine, sodium, potassium, coagulation parameters, hematological indices, and glycemic control were collected. <bold>Results:</bold> ESRD group exhibited significantly higher AST (P=0.012) and ALP (P&lt;0.001) levels, and lower serum albumin (P&lt;0.001) compared to controls. No significant differences in ALT and total bilirubin were observed. Diabetic ESRD patients had significantly higher AST (P=0.017), ALT (P=0.003), serum albumin (P=0.034), and ALP (P=0.013) levels compared to non-diabetic ESRD patients. The urea reduction ratio and kt/v were significantly lower in diabetic ESRD patients (P=0.005 and P=0.039, respectively). <bold>Conclusion:</bold> ESRD patients, particularly those with diabetes, have significantly altered liver enzyme profiles than general population. These results may change our view to liver enzymes levels in ESRD patients particulary ESRD patients with diabetes in routine monthly follow up and in other occasions.