Liver function test abnormalities in hemodialysis patients with hepatitis C virus antibody.

Anti-HCV was examined in 462 patients on chronic hemodialysis (HD) in Fukuoka in 1990. Anti-HCV was detected in 90 (19.5%) of the HD patients. The anti-HCV positive rate was found to be 18.2% in patients with normal (<40IU/l) and 40.7% in patients with an elevated ALT or AST value (≥40IU/l), the difference being significant (p<0.01). However, most of the anti-HCV positive HD patients (79 of the 90 cases, or 87.8%) showed ALT and AST values in the normal range, and only 5.8% of all HD patients (27 of the 462 cases) showed an elevated ALT or AST. These results thus imply that serum transaminase activities are not necessarily appropriate markers of HCV infection in HD patients. Since renal failure patients often show abnormally low serum transaminase activities, an appropriate normal transaminase range for HD patients urgently needs to be established in order to check for HCV infection and to reduce its incidence in HD units.