What question did this study set out to answer?

To describe the clinical utility of serial computed tomography in identifying amiodarone-induced liver injury in a hemodialysis patient.

April 30, 2026Internal MedicineOpen Access

Amiodarone-induced liver damage in a hemodialysis patient: The usefulness of CT for the diagnosis

Q: What is the clinical evidence from this study?

Study design: Case Report. Population: Amiodarone-induced liver damage in end-stage renal disease (n=1). Intervention: Amiodarone.

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Key result

Amiodarone causes reversible liver damage with increased hepatic CT attenuation in a hemodialysis patient.

Why the study?

Amiodarone frequently causes liver damage, but reports regarding this complication in hemodialysis patients are limited.

Does amiodarone cause liver damage in hemodialysis patients, and can CT aid in its diagnosis?

Key Points

To describe the clinical utility of serial computed tomography in identifying amiodarone-induced liver injury in a hemodialysis patient.
Evaluated a 72-year-old male hemodialysis patient treated with 200 mg/day of amiodarone for atrial fibrillation over a 4-year period.
Monitored clinical symptoms, serum liver enzymes (AST and ALT), plasma amiodarone and desethylamiodarone concentrations, and serial abdominal CT hepatic attenuation values.
Hepatic CT attenuation chronologically increased from 70 HU pre-treatment to 102 HU at two years, reaching 137 HU at admission four years after amiodarone initiation.
Laboratory findings revealed an AST of 103 U/L, ALT of 90 U/L, amiodarone plasma level of 693 ng/mL, and desethylamiodarone plasma level of 759 ng/mL.
Abdominal symptoms resolved and AST and ALT levels normalized approximately two months after amiodarone discontinuation.

Study Design

Type

Case Report (n=1)

Multicenter

Structured PICO

Does amiodarone cause liver damage in hemodialysis patients, and can CT aid in its diagnosis?

Population

72-year-old male with end-stage renal disease on maintenance hemodialysis, atrial fibrillation, and sinus node dysfunction (n=1).

Intervention

Amiodarone 200 mg/day orally for 4 years

Outcome

Amiodarone-induced liver damage diagnosed by elevated liver enzymes and increased hepatic CT attenuationsafety

Periodic CT imaging can be useful for the early detection of amiodarone-induced liver damage in hemodialysis patients, even when serum amiodarone levels are not elevated.

Limitations

Single case report.
Abdominal ultrasonography equipment was upgraded during the follow-up period, preventing direct comparison of images.
Liver biopsy was not performed due to the risk of complications from temporarily discontinuing antiplatelet therapy.
Long-term follow-up of liver function and CT values could not be performed because the patient died from postoperative complications of a subsequent surgery.
Liver biopsy was not performed due to antiplatelet therapy
Abdominal ultrasonography equipment was upgraded during follow-up preventing direct comparison

Implication

Hypothesis-generating for hepatic CT attenuation in amiodarone hepatotoxicity among hemodialysis patients; prospective studies needed before clinical adoption.

Abstract

Amiodarone is used to treat life-threatening ventricular arrhythmias and atrial fibrillation; however, it frequently causes liver damage. We report the case of a 72-year-old hemodialysis patient who developed nausea, anorexia, and constipation, accompanied by elevated liver enzymes and a progressive increase in hepatic CT attenuation, which led to the diagnosis of amiodarone-induced liver damage. Abdominal symptoms and the liver function improved after drug discontinuation. Although reports on dialysis patients are limited, understanding this risk and performing periodic CT in addition to blood tests may facilitate early detection and improve the prognosis.

Discussion

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Cite This Study

Yoshikane et al. (2026) conducted a case report in Amiodarone-induced liver damage in end-stage renal disease (n=1). Amiodarone was evaluated. In a 72-year-old hemodialysis patient, amiodarone therapy caused liver damage characterized by elevated liver enzymes and increased hepatic CT attenuation (137 HU), which improved after drug discontinuation.

synapsesocial.com/papers/69f2f0991e5f7920c6386b94 https://doi.org/10.2169/internalmedicine.6863-25

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Implication

Hypothesis-generating for hepatic CT attenuation in amiodarone hepatotoxicity among hemodialysis patients; prospective studies needed before clinical adoption.

Amiodarone-induced liver damage in a hemodialysis patient: The usefulness of CT for the diagnosis

Key Points

Study Design

Structured PICO

Limitations

Implication

Abstract

Discussion

Cite This Study

Amiodarone-induced liver damage in a hemodialysis patient: The usefulness of CT for the diagnosis

Key Points

Study Design

Structured PICO

Limitations

Implication

Abstract

Discussion

Cite This Study

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