In orer to assess the frequency of significant liver diseases in HBsAg positive patients with end stage renal disease (ESRD), 47 ESRD patients carrying HBsAg underwent peritoneoscopic liver biopsy. Chronic liver diseases were observed in 32 cases
(liver
cirrhosis 10, chronic active hepatitis (CAH) with cirrhosis 3, CAH 8, chronic persistent hepatitis 11 cases), nonspecific reactive hepatitis in 8 cases, and normal histology in 7 cases. The hepatic transaminases (AST & ALT) were normal in 32
cases,
and
elevated in 15 cases. The mean levels of AST and ALT in the group with elevated transaminases were 35.3±11.9 IU/L and 38.7±19.6 IU/L, respectively. The significant chronic liver diseases such as liver cirrhosis, CAH with cirrhosis, and CAH were
noted
in 21 cases (44.7%). Among the significant liver disease patients, 7 cases (33.3%) had normal liver function and 14 cases had abnormal liver function. Their mean levels of AST and SLT were 35.8±12.2IU/L and 37.6±19.9 IU/L respectively. there
was
no
significant stat istical difference in the fredquency of the significant statistical difference in the frequency of the significant liver disease according to HBeAg/antiHBe status of these patients. From these results, it can be concluded that,
in
HBsAg
positive patients wits ESRD, the levels of serum transaminases do not correlate with the severity of histologic changes, and HBeAg/antiHBe staus is not good parameter to determine the presence of any significant liver disease. So, we recommend
performing liver biopsy in HBsAg positive patients with EDSRD regardless of their liver function tests and HBeAg/antiHBe status especially in candidates for kidney transplantation.
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