Korean Journal of Nephrology 1993;12(2):136-143.

B형 간염 보균자인 만성 신부전 환자의 간생검 소견 및 간질환

박찬신 , 김기용 , 김홍수 , 최규헌 , 한광협 , 전재윤 , 이호영 , 한대석 , 박찬일 , 김문재

Abstract

In order to assess the frequency of significant liver diseases in HBsAg positive patients with end stage renal disease (ESRD), 47 ESRD patients carrying HBsAg underwent peritoneoscopic liver biopsy. Chronic liver diseases were observed in 32 cases (liver cirrhosis 10, chronic active hepatitis (CAH) with cirrhosis 3, CAH 8, chronic persistent hepatitis 11 cases), nonspecific reactive hepatitis in 8 cases, and normal histology in 7 cases. The hepatic transaminases (AST & ALT) were normal in 32 cases, and elevated in 15 cases. T.he mean levels of AST and ALT in the group with elevated transaminases were 35.3±11.9 IU/L and 38.7±19.6 IU/L, respectively. The significant chronic liver dis- eases such as liver cirrhosis, CAH with cirrhosis, and CAH were noted in 21 cases (44. 7%). Among the signifi- cant liver disease patients, 7 cases (33.39 p) had normal liver function and 14 cases had abnormal liver function. Their mean levels of AST and ALT were 35.8±12.2 IU/L and 37.6±19.9 IU/L, respectively. There was no significant statistical difference in the frequency of the significant liver diseases according to HBeAg/antiHBe status of these patients. From these results, it can be concluded that, in HBsAg positive patients with ESRD, the levels of serum transaminases do not correlate with the severity of histologic changes, and HBeAg/antiHBe status is not a good parameter to determine the presence of any significant liver disease. So, we recommend performing liver biopsy in HBsAg positive patients with ESRD regardless of their liver function tests and HBeAg/antiHBe status especially in candidates for kidney transplantation.