RRML - The influence of hemodialysis on FibroTest parameters

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Nr. 27(4)/2019 DOI:10.2478/rrlm-2019-0040

Research article

The influence of hemodialysis on FibroTest parameters

Olga Hilda Orasan, Iulia Breaban, Andreea Maria Stefan, Adela Sitar-Taut, Sorina Cezara Coste, Ioan Alexandru Minciuna, Teodora Alexescu, Angela Cozma, Laura Urian, Remus Aurel Orasan

Correspondence should be addressed to: Laura Urian

Abstract:

Chronic hepatitis C viral infection is an important cause of morbidity and mortality in patients with end-stage renal disease treated with hemodialysis. Liver fibrosis represents a main determinant of liver disease prognosis and clinical management, and its assessment by liver biopsy can decide treatment allocation. Although liver biopsy is the gold standard for staging liver fibrosis, it is an invasive procedure associated with complications that are more prevalent in patients with end-stage renal disease. FibroTest represents a surrogate marker of fibrosis which evaluates the levels of apolipoprotein A1, total bilirubin, haptoglobin, gamma-glutamyltransferase and α2-macroglobulin, generating a score that indicates the level of fibrosis. Discrepancies were observed in clinical practice between FibroTest score and histopathological findings. The aim of this study was to evaluate how hemodialysis influences the level of each FibroTest parameter and the final score. The systematic literature review conducted by us suggests that hemodialysis induces a reduction in apolipoprotein A1, haptoglobin and bilirubin levels, with an increase in gamma-glutamyltransferase and alpha-2-macroglobulin levels. In conclusion, hemodialysis modifies the levels of FibroTest parameters, suggesting that it may also have an impact on the accuracy of liver fibrosis assessment in hemodialysis patients.

Keywords: hemodialysis, apolipoprotein A1, bilirubin, alpha-2-macroglobulin, haptoglobin, gamma-glutamyltransferase

Received: 15.7.2019
Accepted: 26.9.2019
Published: 21.10.2019

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Orasan OH, Breaban I, Stefan AM, Sitar-Taut A, Coste SC, Minciuna IA, et al. The influence of hemodialysis on FibroTest parameters . Rev Romana Med Lab. 2019;27(4):361-73. DOI:10.2478/rrlm-2019-0040