Evaluation ofRenal Function in Subjects with LiverDisease

Overview

The authors present a brief review on the evaluation of renal function in subjects with liver disease. Methods used commonly in practice (serum creatinine concentration, creatinine clearance on the basis of its urinary excretion predicted value of creatinine clearance according to the formula of Cockcroft and Gault) may under certain circumstances fail in these individuals. The causes of this phenomenon are described: negative interference of the serum concentration of creatinine and bilirubin in hyperbilirubinaemia, reduced creatinine production in muscles in malnutrition, increased distribution volume of creatinine in fluid retention. In the conclusion the authors mention possibilities of a more accurate evaluation of renal function in this group of patients (inulin clearance, assessment of serum concentration of cystatin C). The need of collaboration with a specialized department in case of controversial or obscure findings is emphasized.

Key words:
renal function - liver disease - diagnosis - creatinine - bilirubin.