PURPOSE: To evaluate alanine aminotransferase levels before and after a hemodialysis session and to correlate these values with the hematocrit rate and weight loss during hemodialysis. PATIENTS AND METHODS: The serum alanine aminotransferase levels, hematocrit rate and body weight were measured and correlated before and after a single hemodialysis session for 146 patients with chronic renal failure. An receiver operating characteristic (ROC) curve for the serum alanine aminotransferase levels collected before and after hemodialysis was plotted to identify hepatitis C virus-infected patients. RESULTS: The mean weight loss of the 146 patients during hemodialysis was 5.3% (p < 0.001). The mean alanine aminotransferase levels before and after hemodialysis were 18.8 and 23.9 IU/, respectively, denoting a significant 28.1% increase. An equally significant increase of 16.4% in the hematocrit rate also occurred after hemodialysis. The weight loss was inversely correlated with the rise in both the alanine aminotransferase level (r = 0.3; p < 0.001) and hematocrit rate (r = 0.5; p < 0.001). A direct correlation was found between the rise in alanine aminotransferase levels and the hematocrit during the hemodialysis session (r = 0.4; p < 0.001). Based on the ROC curve, the upper limit of the normal alanine aminotransferase level should be reduced by 40% relative to the upper limit of normal if the blood samples are collected before the hemodialysis session or by 60% if blood samples are collected after the session. CONCLUSION: In the present study, significant elevations in the serum alanine aminotransferase levels and hematocrit rates occurred in parallel to a reduction in body weight after the hemodialysis session. These findings suggest that one of the factors for low alanine aminotransferase levels prior to hemodialysis could be hemodilution in patients with chronic renal failure.

A necessidade de maior número de dados sobre prevalência das hepatites por vírus em nosso meio levou-nos a estudar a freqüência das hepatites por vírus na Unidade de Fígado de São Paulo. Foram estudados 154 pacientes atendidos consecutivamente de novembro de 1980 a novembro de 1984. O emprego de marcadores para hepatite A (anti-VHA-IgM), hepatite B (AgHB8, anti-HB6 e anti-HB8) e a ausência dos mesmos para hepatite não-A, não-B (NANB), permitiu verificar a freqüência das mesmas que foi, respectivamente, de 52,6%, 27,3% e 20,1%. A hepatite A caracterizou-se pela maior freqüência em jovens, contacto prévio com doente ou ingestão de alimento suspeito. Na hepatite B os dados epidemiológicos preponderantes foram transmissão parenteral não-transfusional, contacto prévio e alta incidência em profissionais de saúde. Na hepatite NANB predominaram os casos pós-transfusionais (34,5%). Ausência de antecedentes epidemiológicos foi observada em 30-40% dos pacientes dos três grupos.

As few reports on the prevalence of each type of viral hepatitis have been published in our country, we studied 154 patients with acute viral hepatitis consecutively seen at the Liver Unit from November 1980 to November 1984. The frequency of hepatitis A, B and non-A, non-B was 52.6%, 27.3% and 20.1% respectively. Greater frequency in young people, previous contact with infected patients and ingestion of suspected foods were the predominant epidemiological features in the hepatitis A group. Hepatitis B was characterized by the parenteral, non-transfusional exposure, previous contact and a high occurence in health-care workers. A history of blood transfusion was a significant finding in the hepatitis non-A, non-B group. Finally, the routes of transmission were unknown in 30-40% of the three groups of patients.