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Open access

R. Mihaylov, B. Pencheva, D. Stoeva and A. Ruseva

Abstract

Detecting new units of pathogenesis in the liver fibrosis due to alcoholism, chronic viral Hepatitis B and C, non-alcoholic fatty liver disease (NAFLD), autoimmune, parasitic and metabolic diseases and other, reveals perspective for new non-invasive serum biomarkers. In fibrosis, from the wide variety of markers enzymes, proteins and cytokines are mainly used. While direct biomarkers reflect the stage of fibrosis and fibrinogenesis, indirect markers allow assessment of the general liver functions. The combination of direct and indirect markers increases the diagnostic reliability and therefore these panels and indices are investigated quite intensively in recent years in order to decrease the number of liver biopsies without completely replace it, which is still regarded as the reference method.

Open access

R. Mihaylov, B. Pencheva, D. Stoeva, N. Marinova, S. Krivoshiev and G. Michailov

Summary

Vitamin D deficiency is fequently observed in chronic kidney disease. We conducted this study to determine the concentration of the above-mentioned parameters and the correlation between them in order to optimize therapy with vitamin D in patients with end-stage renal disease (ESRD) on hemodialysis. In 53 patients on hemodialysis due to ESRD, vitamin D [Calcidiol (25(OH)D], parathyroid hormone (PTH), calcium, phosphorus, albuminuria, albumin:creatinine ratio (ACR) and other parameters have been followed up. Analysis of the levels of vitamin D has been carried out by High Performance Liquid Chromatography (HPLC), the PTH is determined by the system Centaur XP, Siemens Diagnostic, Electro-chemiluminescence immunoassay (ECLIA), and for albumin in urine we used immunological method [Miltigent microalbumin assay (Abbott Laboratories Diagnostics). We found out deficiency and insufficiency of vitamin D in 56.6% and 37.7%, as well as average 4.5 times increase in the PTH, hyperphosphatemia, hypocalcemia, albuminuria (A2 or A3), over 10 times increase in the ACR, secondary hyperparathyroidism. We registered a negative correlation between vitamin D and PTH. We confirmed the increase in creatinine and cystatin C in the patients on hemodialysis. There are few literature data for patients on hemodialysis, however, regarding the extent of the vitamin deficiency and its relationship with PTH, albuminuria, calcium, phosphorus, etc. Our data have indicated that patients on hemodialysis due to ESRD are associated with high incidence of vitamin D insufficiency or deficiency.