Reference Values of Certain Serum Indicators of Liver Fibrosis.

BACKGROUND: Liver fibrosis shows a continuously increasing trend worldwide, due to alcohol abuse, obesity, and, to a lesser extent, chronic hepatitis B and C. Biopsy is still considered the "gold standard" for diagnosis of liver fibrosis. However, it has a number of limitations, such as invasiveness, high cost, need for specialists to conduct and interpret biopsy results, risk of complications, inability to dynamically monitor the pathological process, low patient compliance, and uneven fibrosis distribution. Therefore, there is an increasing demand for non-invasive serum markers that are characterized by easy implementation, low cost, possible repeatability, and high patient compliance. METHODS: For a period of two years, 82 clinically healthy, middle aged subjects, mean age 40.5 ± 12.37 years, range 21 - 67 years, were studied. The group was tested for platelet count, prothrombin time, and the following biochemical parameters: Cholesterol - total, HDL, LDL; AST; ALT; GGT; total bilirubin, alfa-2-macroglobulin; haptoglobin and ELF (Enhanced Liver Fibrosis). RESULTS: Reference values of a large number of serum indicators of liver fibrosis are disputable and unspecified. A direct proportional and moderate correlation was found between the BMI and AST, ALT, INR, APRI, GPRI, and Forns Index. CONCLUSIONS: We present our original reference values for ELF, AST/ALT, ARPI, GRPI, Fib 4, and Forns Index in 82 clinically healthy subjects.

Albuminuria and Glomerular Filtration in Patients with Essential Hypertension.

BACKGROUND: Essential hypertension (EH) is a widespread disease. One frequent complication of EH is Chronic Kidney Disease (CKD), whose diagnosis is delayed due to its asymptomatic course. The purpose of this study is to determine the involvement of the kidneys in patients with EH by biomarkers for kidney damage (albuminuria) and glomerular filtration rate (GFR) with creatinine and cystatin C. METHODS: We observed a control group of 153 healthy volunteers and a group of 150 patients with EH. The biomarkers we tested were urinary albumin, ACR, total protein, and PCR. The GFR was calculated by the CKD-EPI formula using creatinine simultaneously and by the combined formula CKD-EPI using creatinine and cystatin C. RESULTS: The obtained results for the studied biomarkers in the control group are similar to the ones reported in the literature. In the group of patients with EH (at the time of study none of which had been diagnosed with CKD) we observed albuminuria A2 in 59 of the patients (39.9%) and none with albuminuria A3; increased ACR in 60 patients (40%); PCR above reference range in 42 patients (28%). GFRR was < 60 mL/min/1.73 m2 in 13 patients (8.6%). CONCLUSIONS: These results show that albuminuria A2 and ACR are sensitive, while GFR is a specific biomarker for kidney damage. For patients with EH, a timely follow-up of these biomarkers is necessary in order to decrease the progression of the kidney damage to Chronic Kidney Failure, cardiac complications, and premature mortality.