Abnormal liver function tests

Liver disease is a clinical priority area identified by the RCGP, due to increasing levels of morbidity and mortality. Liver disease causes an estimated 8500 premature deaths in the UK annually, predominantly from a rise in non-alcoholic fatty liver disease, alcohol-related liver disease, and viral hepatitis. There has been a corresponding increase in liver function tests (LFTs) ordered from primary care, often as part of medication reviews or monitoring of chronic disease. GPs will therefore encounter an increasing number of abnormal LFTs in patients asymptomatic of liver disease. This article outlines a framework for investigating abnormal LFTs in primary care.