Effects of pyridoxal phosphate in analysis of aminotransferase activity in patients undergoing hemodialysis

Background and Aims: Factors like hemodilution, pyridoxine deficiency, hepatocyte growth factor and uremic toxins have been proposed for low aminotransferase activity in chronic kidney disease (CKD) patients undergoing haemodialysis. This may be a concerning factor in making diagnosis of liver disorders like hepatitis in patients undergoing haemodialysis. In present study we attempted to find out the cause of hypoaminotransferasemia in chronic kidney diseases and biochemical principle of analysis. Materials and Methods: Serum levels of various biochemical parameters are measured in CKD patients undergoing haemodialysis. The serum activities of Aspartate Aminotransferase (AST) and Alanine Aminotransferase (ALT) are determined (with and without the addition of PLP) in a group of 176 patients undergoing hemodialysis Results: Serum AST and ALT activities are significantly lower in the CKD patients compared to the control group (P value 0.0003 and 0.001 respectively). Measurement of activity with pyridoxal phosphate containing reagent resulted into a significant increase in values comparison to without pyridoxal phosphate. The percentage activation is higher in patients as compared to controls. Conclusion: The upper limit of reference range for aminotransferases in CKD patients undergoing hemodialysis should be considered lower as compared to healthy subjects. Reagent containing pyridoxal phosphate is considered appropriate for aminotransferase activity measurement.