Evaluation of liver function biomarkers, blood pressure, and anthropometric parameters among chronic kidney disease patients: Laboratory-based cross-sectional study in Northwest Ethiopia.

Background: Chronic kidney disease (CKD) is a non-communicable disease leading to a progressive decline in kidney functions and complications like liver disorders. Serum levels of liver parameters such as aminotransferases and bilirubin are important biomarkers for the diagnosis of liver diseases. Studies on the effect of CKD with and without end-stage renal disease (ESRD) on the levels of liver biomarkers in Ethiopia are limited. Hence, this study aimed to assess liver biomarkers, blood pressure (BP) and anthropometric indices in CKD patients attending a renal clinic of Felege Hiwot Comprehensive Specialized Hospital(FHCSH) in Bahir Dar, Ethiopia.

Method: A hospital-based cross-sectional study was conducted among 100 CKD patients attending the renal clinic of FHCSH in Bahir Dar, Ethiopia. Data were collected using a structured questionnaire through face-to-face interview. BP and anthropometric parameters were measured based on the standard procedures. About 5 ml of serum was used to analyzeliver parameter using automated chemistry analyzer. All data analyses such as independent sample t-testand one-way ANOVA were done using SPSS version 25.0. Besides, Pearson's correlation analysis and multiple linear regression were done to identify predictors of liver biomarkers in CKD patients. P-value< 0.05 were considered statistically significant.

Results: The mean serum levels of AST and ALT were significantly lower in CKD patients under dialysis when compared to CKD patients with no dialysis ( < 0.05). These enzymes were positively and negatively correlated with eGFRand the severity of CKD, respectively. However, there were no significant differences in bilirubin level between different stages of CKD. There was also a significant increase (p < 0.05) in the levels of AST and ALT with BMI.There was also a significant rise of SBP and DBP in CKD patients under dialysis compared to CKD patients not in dialysis.

Conclusion: Aminotransferases were significantly lower in CKD patients undergoing dialysis than in CKD patients not undergoing dialysis, warranting the need fora separate standard reference ranges or using other diagnostic criteria to diagnose liver comorbidities in CKD patients. The levels of AST and ALT in CKD patients were also significantly increased with BMI. Besides, BP was significantly elevated with the severity of CKD, indicating the more advanced the CKD is, the higher BP.