Relationship between liver function tests & cardiovascular risk factors in stage 3-5 pre-dialysis chronic kidney disease

Indian J Med Res. 2022 Mar;155(3&4):397-402. doi: 10.4103/ijmr.IJMR_1777_19.

Abstract

Background & objectives: Cardiovascular disease (CVD) remains the leading cause of mortality among patients with chronic kidney disease (CKD). Liver function tests (LFTs) have emerged as markers of CVD risk in some population-based studies. Hence, in the present study the relation between LFTs and biochemical cardiovascular risk factors (CRFs) were evaluated in CKD patients.

Methods: A total of 246 patients with stage 3-5 pre-dialysis CKD were enrolled. Demographics, LFTs [alanine aminotransferase (ALT), aspartate aminotransferase (AST) and gamma-glutamyltransferase (GGT)] and biochemical CRFs were recorded retrospectively. Glomerular filtration rate (GFR) was calculated using CKD-EPI equation.

Results: ALT was positively correlated with GFR, albumin, triglyceride and 25-hydroxyvitamin D and negatively correlated with CRP and intact parathyroid hormone (iPTH); AST was positively correlated with GFR, albumin, high-density lipoprotein cholesterol (HDL-C) and 25-hydroxyvitamin D and negatively correlated with CRP and iPTH; GGT was positively correlated with GFR, CRP and triglyceride and negatively correlated with HDL-C. In diabetic patients, ALT correlated positively with GFR; AST correlated positively with GFR and HDL-C, but correlated negatively with iPTH. In the correlation analysis between GFR and CRF, GFR was positively correlated with albumin, triglyceride and 25-hydroxyvitamin D and negatively correlated with CRP, iPTH and albuminuria in both total study population and diabetic group. A partial correlation analysis revealed no correlation between LFTs and CRFs after being controlled for GFR.

Interpretation & conclusions: The results of the present study suggest that the relationship between LFTs and biochemical CRFs seems to be a function of impaired GFR.

Keywords: Alanine aminotransferase; aspartate aminotransferase; cardiovascular disease; gamma-glutamyltransferase; kidney disease; risk factors.

MeSH terms

  • Alanine Transaminase
  • Albumins
  • Aspartate Aminotransferases
  • Cardiovascular Diseases* / complications
  • Cholesterol, HDL
  • Dialysis
  • Glomerular Filtration Rate
  • Heart Disease Risk Factors
  • Humans
  • Kidney Failure, Chronic*
  • Liver Function Tests
  • Parathyroid Hormone
  • Renal Insufficiency, Chronic* / complications
  • Retrospective Studies
  • Risk Factors
  • Triglycerides
  • gamma-Glutamyltransferase

Substances

  • Albumins
  • Cholesterol, HDL
  • Parathyroid Hormone
  • Triglycerides
  • gamma-Glutamyltransferase
  • Aspartate Aminotransferases
  • Alanine Transaminase